Date:  25 July 1956
Cert: #56-25983
Place of Death: County: Knott      City or Town: Sassafras
Length of stay (in this place): (blank)
Street Address or Location:  home
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Sassafras    Residence on a Farm?:   (blank)
Street Address: rural     Residence inside City Limits?:  (blank)
Full Name:  Polly REYNOLDS 
Date of Death:  25 July 1956 
Sex, Color or Race, Marital Status:  Female, White, Widowed
Date of Birth:   10 March 1875
Age:  81 years
Usual Occupation:  Housewife
Kind of Industry or business: (blank)
Birthplace:  Knott Co., Ky. 
Father's Name:    John THORNSBURY
Mother's Maiden Name:    Jane WEBB
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:    T. K. REYNOLDS
Disease or condition directly leading to death:   Senility
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)
Describe how injury occurred:  (blank)
Time of injury:  (blank)
Injury occurred at work: (blank)
Place of injury: (blank)
City, Town or Location, County, State: (blank)
I hereby certify that I attended deceased from 01 July 1956 to 25 July 1956, that I last saw the deceased alive on 22 July 1956, and that death occurred at 6 a.m., from the causes and on the date stated above.
Date signed:   11 September 1956
Address:   Allock 
Signature:  A. B. Pigman, M.D. 
Burial, Cremation or Removal: Burial
Date:   27 July 1956
Name of Cemetery or Crematory:   Reynolds Cemetery
Location:    Knott Co., Ky.
Date received by local registrar:   21 (illegible) 1956
Registrar's Signature: Myrtle Slone
Funeral director & address: Engle Funeral Home, Hazard, Ky.
Transcribed by Debbie Tamborski, 25 April 2012