Date:   12 April 1941
Cert:   13044 
Place of Death: County: Knott     City or Town: Lackey
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Floyd
City or Town:  Melvin, Ky.
Full Name:  Agness SINGLETON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Hobert SINGLETON
Age of husband or wife if alive:  18 years
Birth date of deceased:  12 September 1924
Age: 16 years, 07 months
Birthplace:  Floyd Co.
Occupation:  Housework
Industry or business: (blank)
Father Name:  Jaruie CAUDILL
Father Birthplace:  Floyd Co.
Mother Maiden Name:  Luverna OSBORNE
Mother Birthplace:  Floyd Co.
Informant:  Hobert SINGLE, Melvin, Ky.
Burial Place:  Melvin
Date:  13 April 1941
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar:  13 May 1941
Registrar's Signature:  Macie Miller
Date of Death:  12 April 1941
I hereby certify that I attended deceased from 07 April 1941 to 12 April 1941, that I last saw her alive on 12 April 1941, and that death occurred on the date stated above at 10:00 p.m.
Immediate cause of death:  Uterine Dys(illegible) Flat pelvis
Duration: (blank)
Due to: (blank)
Other conditions:  Subinpalution
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: W. L. Stumbo, Lackey, Ky.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 15 October 2010