Date: 18 April 1943
Cert: 15258
Place of Death: County: Knott City or
Town: Amburgy
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: Amburgy
Full Name: Una Christine MULLINS
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Infant
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 28 March 1943
Age: 21 days
Birthplace: Amburgy, Knott Co., Ky.
Occupation: (blank)
Industry or business: (blank)
Father Name: D. D. MULLINS
Father Birthplace: Smithboro, Ky.
Mother Maiden Name: Ada B. EVERAGE
Mother Birthplace: Smithsboro, Ky.
Informant: D. D. MULLINS, Amburgy, Kentucky
Burial Place: Irishman Creek
Date: 20 April 1943
Signature of funeral director: Friends, Amburgy, Ky.
Date received by local registrar: March 1945
Registrar's Signature: Rose B. Craft,
Acting Registrar, Per B. Carns
Date of Death: 18 April 1943
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 (blank)
Immediate cause of death: Premature development
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. R. Aker, M.D., Anco, Ky.
Date signed: 28 March 1943
Transcribed by Debbie Tamborski, 25 October 2010 |