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DEATH
CERTIFICATE
BETTY MULLINS
Date 24 September 1940
Cert: 24141
Place of Death: County: Kenton City or Town:
Covington
Name of Hospital or Institution: Wm. Booth Memorial
Length of stay in hospital or community: 17 days
Usual Residence of Deceased: State: Kentucky County:
Knott
City or Town: Amburgy
Full Name: Betty MULLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: (blank)
Birth date of deceased: (blank)
Age: 57 years
Birthplace: Kentucky
Occupation: Housewife
Industry or business: (blank)
Father Name: Samuel MULLINS
Father Birthplace: Amburgey, Ky.
Mother Maiden Name: Martha MULLINS
Mother Birthplace: Amburgey, Ky.
Informant: Newton AMBURGEY, Amburgey, Ky.
Burial Place: Jackson, Ky.
Date: 27 September 1940
Signature of funeral director: T. M. Sumidler,
Covington, Ky.
Date received by local registrar: 27 September 1940
Registrar's Signature: Mrs. H. C. White
Date of Death: 26 September 1940
I hereby certify that I attended deceased from 09 September
1940 to 26 September 1940, that I last saw her alive on 26
September 1940, and that death occurred
on the date stated above at 7 p.m.
Immediate cause of death: Acute myocardial failure
Due to: Hyperthyroidism myocardia
Major findings of operations: Large cyster (illegible)
thyroid
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature: Leslie M. Budnan, M.D., 441 Vine St., Cincinnati,
OH
Date signed: 27 September 1940
Transcribed by Debbie Tamborski, 31 January 2010 |
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