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DEATH
CERTIFICATE
ARMEINTA STACY
Date 11 March 1914
Cert: 07918
Place of Death: Vot. Precinct: McRoberts, Jenkins, Letcher
Co., KY
Full Name: Armeinta STACY
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: June 1868
Age: 45 years, 08 months
Occupation: Housewife
Birthplace: Knott Co., Ky.
Name of Father: Thomas KELLEY
Birthplace Father: Knott Co., Ky.
Maiden name of Mother: Manerva YOUNG
Birthplace Mother: Knott Co., Ky.
Informant/Address: W. T. KELLEY, McRoberts, Ky.
Filed: 11 March 1914
Registrar: John Collins
Death Date: 11 March 1914
I hereby certify that I attended deceased from 24 October
1913, to 09 March 1914, that I last saw her alive on 09 March
1914, and that death occurred, on the date stated above, at
1:30 p.m.
Cause of Death: (illegible) regurgitation of heart
Duration: 08 years
Contributory: Rheumatism
Signed/Address: F. M. Williams, M.D., 11 March 1914, McRoberts,
Ky.
Length of residence at place of death: 01 year, 04 months, 11
days
Length of residence in state: 45 years, 08 months
Where was disease contracted: Yerkes, Perry Co., Ky.
Former or usual residence: Canarel City, Ky.
Place of Burial or Removal: Elec, Knott Co., Ky.
Date of Burial: 13 March 1914
Undertaker/Address: none
Transcribed by Debbie Tamborski, 25 February 2010 |
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