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DEATH
CERTIFICATE
ELIZABETH TRIPLETT
Date 28 December 1942
Cert: 03335
Place of Death: County: Floyd City or Town:
Martin
Hospital or Institution: Martin Gen. Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Wheelwright
Full Name: Elizabeth TRIPLETT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Mathew TRIPLETT
Age of husband or wife if alive: 41 years
Birth date of deceased: 17 January 1903
Age: 39 years, 11 months, 11 days
Birthplace: Knott County
Occupation: Domestic
Industry or business: (blank)
Father Name: Alex CONLEY
Father Birthplace: Knott Co.
Mother Maiden Name: Marthie HANDSHEW
Mother Birthplace: Knott Co.
Informant: Matthew TRIPLETT, Wheelwright, Ky.
Burial Place: Wayland, Ky.
Date: 29 December 1942
Signature of funeral director: G. D. Ryan, Martin, Ky.
Date received by local registrar: 31 December 1942
Registrar's Signature: Winifred Norris
Date of Death: 28 December 1942
I hereby certify that I attended deceased from 27 December
1942 to
28 December 1942, that I last saw her alive on 28 December
1942, and that death occurred on the date stated above at 5:00
p.m.
Immediate cause of death: (blank)
Duration: (blank)
Due to: Diabetes Mellitus
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. Allen, M.D., Martin, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 30 May 2010 |
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