Date:  06 February 1940
Cert:  10427
Place of Death: County: Knott     City or Town: Lackey
Name of Hospital or Institution: Stumbo Mem. Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County:  Knott
City or Town:  Lackey, Ky.
Full Name:  Lacy TRIPLETT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of:  Rebbaca TRIPLETT
Age of husband or wife if alive:  20 years
Birth date of deceased:  28 July 1904
Age: 35 years, 06 months, 08 days
Birthplace:  Knott Co., Ky.
Occupation:  Barber
Industry or business: (blank)
Father Name:  Zack TRIPLETT
Father Birthplace:  Knott Co.
Mother Maiden Name:  Elaza MARTIN
Mother Birthplace:  Knott Co., Ky.
Informant:  Savolis TRIPLETT, Mousie, Ky.
Burial Place:  Mousie, Ky.
Date:  07 February 1940 
Signature of funeral director:  G. D. Ryan, Martin, Ky.
Date received by local registrar:  14 February 1940
Registrar's Signature:  Macie Miller
Date of Death:  06 February 1940
I hereby certify that I attended deceased from 03 February 1940 to 06 February 1940, that I last saw him alive on 06 February 1940, and that death occurred on the date stated above at 5:20 p.m.
Immediate cause of death:  Internal hemorrhage
Duration: (blank)
Due to: Gun shot wounds
Major findings of operations: (blank)
Accident, suicide, or homicide: Homicide
Date of occurrence: 03 February 1940
Where did injury occur: In public place
While at work: No
Means of injury: Gun shot
Signature & Address:  A. Rabin, M.D., Martin
Date signed:  (blank)
Transcribed by Debbie Tamborski, 07 October 2010