Date:  16 April 1956
Cert:  #56-7910
Place of Death: County: Knott      City or Town: Carrie - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Carrie    Street Address: (blank)
Full Name:  Martin PATRICK
Date of Death:  16 April 1956
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth:  August 1900
Age: 55 years
Usual Occupation: Miner
Kind of Industry or business: (blank)
Birthplace:   Knott Co., Ky.
Father's Name:  Martin PATRICK
Mother's Maiden Name:  Peggy COMBS
Was deceased ever in armed forces: No
Social Security No.: XXX-XX-XXXX
Informant:  Mrs. Martin PATRICK
Disease or condition directly leading to death: Cancer of Stomach
Interval between onset and death:  (blank)
Due to:  (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 28 February 1956 to 16 April 1956, that I last saw the deceased alive on 16 March 1956, and that death occurred at 8 p.m., from the causes and on the date stated above.
Date signed:   20 April 1956
Address:  Hindman, Ky.
Signature:  M. F. Kelley, M.D.
Burial, Cremation or Removal: Burial
Date:  18 April 1956
Name of Cemetery or Crematory:  Family
Location:  Bearville, Ky.
Date received by local registrar: 20 April 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 26 March 2012