Date:   20 June 1943
Cert:   15292 
Place of Death: County: Knott     City or Town: Lackey, Ky., Rural
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: 03 days
Usual Residence of Deceased: State: Kentucky  County: Knott
City or Town:  Mousie     Rural
Full Name:  Connie TRIPLETT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Infant
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  07 June 1943
Age: 13 days
Birthplace: Mousie, Ky.
Occupation:  (blank)
Industry or business: (blank)
Father Name:  Otis TRIPLETT
Father Birthplace:  Mousie, Ky.
Mother Maiden Name:  WICKER
Mother Birthplace:  Ky.
Informant:  Otis TRIPLETT, Mousie, Ky.
Burial Place:  Mousie, Ky.
Date:  21 June 1943
Signature of funeral director: Family, Mousie, Ky.
Date received by local registrar:  27 March 1945
Registrar's Signature:  (blank) Per B. Carns
Date of Death:  20 June 1943
I hereby certify that I attended deceased from 17 June 1943 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: Deformity of congenital heart
Duration: (blank)
Due to: 13 day baby
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: A. N. Hodge, M.D., Lackey, Ky.
Date signed:  27 March 1945
Transcribed by Debbie Tamborski, 29 October 2010