Date:  12 December 1955
Cert:  #26883
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 - Rural    Street Address: (blank)
Full Name:  Ishmael STACY
Date of Death:  12 December 1955
Sex, Color or Race, Marital Status:  Male, White, Widowed
Date of Birth:  31 May 1915
Age: 40 years
Usual Occupation:  Construction
Kind of Industry or business: (blank)
Birthplace:  Perry Co., Ky.
Father's Name:  William STACY
Mother's Maiden Name:  Jennie WILLIAMS
Was deceased ever in armed forces: No
Social Security No.: 405-01-4979
Informant:  (blank)
Disease or condition directly leading to death:  Punctured Aorta & vital vessels in chest
Interval between onset and death:  none
Due to:  Gun shot
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: Yes
Accident, suicide, or homicide: Homicide
Place of injury:  Home of ex wife
City or Town, County, State: Carrie, Knott, Ky.
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to (blank), that I last saw the deceased alive on (blank), and that death occurred at (blank), from the causes and on the date stated above.
Date signed: 12 December 1955
Address:  Hindman, Ky.
Signature:  John Everage, Coroner, Knott Co.
Burial, Cremation or Removal: Burial
Date:  15 December 1955
Name of Cemetery or Crematory: Stacy
Location:  Ary, Ky.
Date received by local registrar:  01 January 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 19 June 2011