Date: 08 November 1945
Cert: 23984
Place of Death: County: Knott City or
Town: Elic, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Elic Rural
Full Name: Jeanette MULLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 26 January 1945
Age: 09 months, 13 days
Birthplace: Elic, Knott Co., Ky.
Occupation: None
Industry or business: (blank)
Father Name: Roosevelt MULLINS
Father Birthplace: Elic, Knott Co., Ky.
Mother Maiden Name: Victoria KAZEE
Mother Birthplace: Indian Head, Perry Co.,
Ky.
Informant: (blank)
Burial Place: Elic, Ky.
Date: 09 November 1945
Signature of funeral director: Neighbors, Elic, Ky.
Date received by local registrar: 14 November 1945
Registrar's Signature: Rose B. Craft
Date of Death: 08 November 1945
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 4 p.m.
Immediate cause of death: Burned to death
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Accident
Date of occurrence: 08 November 1945
Where did injury occur: In home - Mother left children while
she went to coal bank for coal. Returning, she found the
house in flames. The baby burned to death.
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. W. Duke, M.D., Hindman, Ky.
Date signed: 14 November 1945
Transcribed by Debbie Tamborski, 29 November 2010 |