Date:  30 September 1954
Cert:  22400 
Place of Death: County: Knott      City or Town: Lackey
Length of stay (in this place): (blank)
Name of Hospital or Institution:  Stumbo Memorial
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town:  Mousie    If rural give location: (blank)
Full Name:  Millard B. RICE 
Date of Death:  30 September 1954 
Sex, Color or Race, Marital Status: Male, White, Married 
Date of Birth:  18 October 1879 
Age:  75 years
Usual Occupation:  Farmer
Kind of Industry or business: (blank)
Birthplace:  (blank) 
Father's Name:  Andy RICE 
Mother's Maiden Name:  Katherine CONLEY 
Was deceased ever in armed forces: (blank)
Social Security No.:  (blank)
Informant:  Mrs. Millard RICE
Disease or condition directly leading to death: Congestive heart failure due to
Interval between onset and death:  01 day
Due to:  Myocardial infarction & heart block
Interval between onset and death:  06 months
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 01 June 1954 to 30 September 1954, that I last saw the deceased alive on 30 September 1954, and that death occurred at 1:00 p.m., from the causes and on the date stated above.
Date signed:  05 November 1954
Address:  Lackey, Kentucky
Signature:  Charles L. Roach, M.D.
Burial, Cremation or Removal: Burial
Date:  03 October 1954
Name of Cemetery or Crematory:  Wm. Hicks
Location:  Mousie, Ky.
Date received by local registrar: 05 November 1954
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 23 February 2011