Date:    12 February 1946
Cert:    04585 
Place of Death: County: Knott   City or Town: Sasfras  Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Sassafras     Rural 
Full Name:  Mary STACY 
If Veteran Name War: (blank)
Social Security No.:  (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Simon STACY
Age of husband or wife if alive: 77 years
Birth date of deceased:  (blank) 
Age:  77 years
Birthplace:  Knott Co., Ky. 
Occupation:  House Wife 
Industry or business:  (blank)
Father Name:  Robert CORNETT 
Father Birthplace:  Perry 
Mother Maiden Name:  Adline BRASHIR  
Mother Birthplace:   Perry Co., Ky. 
Informant:  Robert S. CORNETT, Sasfrass, Ky.
Burial Place:  Cornett Hill 
Date:  13 February 1946 
Signature of funeral director:  Maggard, Hazard, Ky.
Date received by local registrar:  28 February 1946 
Registrar's Signature:  Mrs. Rose B. Craft
Date of Death:  12 February 1946 
I hereby certify that I attended deceased from (blank) to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at 11:15 p.m.
Immediate cause of death:  Arteriosclerosis 
Duration: (blank)
Due to:  (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work:  (blank)
Means of injury: (blank)
Signature & Address:  C. L. Combs, M.D., Hazard, Ky.
Date signed:  15 February 1946 
Transcribed by Debbie Tamborski, 15 December 2010