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DEATH
CERTIFICATE
KELLEY TRIPLET
Date 15 January 1918
Cert: 09919
Place of Death: Voting Precinct: Lackey, Martin, Floyd Co.,
Ky.
Full Name: Kelley TRIPLET
Sex, Color or Race, Marital Status: Male, White, Single
Date of Birth: 31 July 1900
Age: 18 years, 05 months, 14 days
Occupation: Farmer
Birthplace: Knott Co., Ky.
Name of Father: Wm. TRIPLET
Birthplace Father: Knott Co., Ky.
Maiden name of Mother: Melvina CASTLE
Birthplace Mother: Virginia
Informant/Address: Bill TRIPLETT, Lackey, Ky.
Filed: (blank)
Registrar: G. S. Howard
Death Date: 15 January 1918
I hereby certify that I attended deceased from 14 January 1918,
to 15 January 1918, that I last saw him alive on 15 January
1918, and that death occurred, on the date stated above, at 4
a.m.
Cause of Death: Accidently fell from a moveing train and
fractured base of his skull [sic]
Duration: 02 days
Contributory: (blank)
Signed/Address: M. M. Collins, M.D.,
Where was disease contracted if not at place of death:
Lackey, Ky.
Former or usual residence: Lackey, Ky.
Place of Burial or Removal: Hayes Cemetery
Date of Burial: 16 January 1918
Undertaker/Address: B. L. Hughes, Lackey, Ky.
Transcribed by Debbie Tamborski, 05 March 2010 |
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