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DEATH
CERTIFICATE
NANCY MULLINS
Date: 21 September 1945
Cert: 19681
Place of Death: County: Lincoln City or Town:
Stanford
Hospital or Institution: Stanford Hospital
Length of stay in hospital or community: days
Usual Residence of Deceased: State: Kentucky County: Lincoln
City or Town: Waynesburg
Full Name: Nancy MULLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widow
Husband or Wife of: Wall MULLINS
Age of husband or wife if alive: (blank)
Birth date of deceased: 01 October 1870
Age: 74 years, 11 months, 21 days
Birthplace: Knott County
Occupation: Housewife
Industry or business: (blank)
Father Name: Wilson CAUDILL
Father Birthplace: Knott County
Mother Maiden Name: (blank)
Mother Birthplace: (blank)
Informant: F. M. MULLINS, Waynesburg, Ky.
Burial Place: Clear Fork Cem.
Date: 23 September 1945
Signature of funeral director: J. M. Reynolds, Waynesburg, Ky.
Date received by local registrar: 22 September 1945
Registrar's Signature: Gretchen Southard
Date of Death: 21 September 1945
I hereby certify that I attended deceased from 28 August 1945 to
21 September 1945, that I last saw him alive on 21 September
1945, and that death
occurred on the date stated above at 4:00 p.m.
Immediate cause of death: Hypostatic pneumonia (illegible)
Duration: 04 days
Due to: Ruptured appendix & Diabetes Mellitus
Duration: 04 days
Major findings of operations: Appendectomy 28 August 1945
generalized peritonitis (illegible)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: H. I. Gernaline, M.D., Stanford
Date signed: 21 September 1945
Transcribed by Debbie Tamborski, 06 June 2010 |
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