Date 12 January 1947
Cert: 11580
Place of Death: County: Knott      City or Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Litt Carr      Rural
Full Name: Mrs. Paulina TOLIVER NICKLES
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Herbert NICKLES
Age of husband or wife if alive: 24 years
Birth date of deceased: 04 October 1897
Age: 49 years, 03 months, 08 days
Birthplace: Smithsboro, Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Jack COMBS
Father Birthplace: Knott Co.
Mother Maiden Name: Lucy COMBS
Mother Birthplace: Knott Co., Ky.
Informant: Eula NAPIER, Whitesburg, Ky.
Burial Place: Litt Carr, Ky.
Date: 13 January 1947
Signature/Address of funeral director: Friends, Litt Carr, Ky.
Date received by local registrar: 31 May 1947
Registrar's Signature: Rose B. Craft
Date of Death: 12 January 1947
I hereby certify that I attended deceased from 09 January 1947 to 12 January 1947, that I last saw h-- alive on 12 January 1947, and that death occurred on the date stated above at 3:15 a.m.
Immediate cause of death: heart failure
Duration: 03 days
Due to: Coronary occlusion & Cardiac decompensation
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: C. M. Aker, M.D., Lackey, Ky.
Date signed: 31 May 1947
Transcribed by Debbie Tamborski, 20 December 2010