DEATH CERTIFICATE

 MARY STAMPER

Date:   15 July 1943
Cert:   20678 
Place of Death: County: Knott     City or Town: Hindman, Ky.
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:  Hindman - Rural
Full Name:  Mary STAMPER
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  25 May 1943
Age: 01 months, 21 days
Birthplace:  Knot County
Occupation:  Infant
Industry or business: (blank)
Father Name:  Hiram STAMPER
Father Birthplace:  Knott Co., Ky.
Mother Maiden Name:  Martha KELLEY
Mother Birthplace:  Knott Co., Ky.
Informant:  (blank)
Burial Place:  Stewart Cemetery
Date:  16 July 1943
Signature of funeral director: (blank)
Date received by local registrar:  03 September 1943
Registrar's Signature:  Ida Livingston
Date of Death:  15 July 1943
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 (blank)
Immediate cause of death:  Pneumonia
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: J. W. Duke, M.D., Hindman, Ky.
Date signed:  04 October 1943
Transcribed by Debbie Tamborski, 27 October 2010