DEATH CERTIFICATE

ROXIE MULLENS

Date  26 August 1926
Cert: #  9104 
Name:  Roxie MULLENS 
Place of Death: Voting Pct. #18 Pippapass, Knott Co., KY
Female, White, Married
Birth Date:  10 April 1892 
Age:  34 years, 04 months, 16 days
Occupation:  Housewife 
Place of Birth:  Knott Co.
Name of Father:  William HOWARD 
Birthplace Father:  Ky. 
Maiden Name of Mother:  Sarah MAGGARD
Birthplace Mother:  Ky. 
Informant:  (blank)
Death Date:  26 August 1926 
Cause of Death:  Shock from operation at labor causing heart failure 
Signed:  M. F. Kelley, M.D.
Burial Place:  Howard Cemetery
Date of Burial:  27 August 1926 
Undertaker:  Jasper Mullens, Pippapass, Ky. 
File Date:  26 March 1927 
Transcribed by Debbie Tamborski, 19 January 2009