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DEATH
CERTIFICATE
OPAL TRIPLETT
Date: 11 January 1945
Cert: 03108
Place of Death: County: Floyd City or Town:
Martin
Hospital or Institution: Beaver Valley Hosp.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Floyd
City or Town: Bevinsville
Full Name: Opal TRIPLETT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Virgil TRIPLETT
Age of husband or wife if alive: 21 years
Birth date of deceased: 09 January 1921
Age: 24 years
Birthplace: Knott Co., Ky.
Occupation: Domestic
Industry or business: (blank)
Father Name: J. P. MEADE
Father Birthplace: Letcher Co., Ky.
Mother Maiden Name: Polly Ann BENTLEY
Mother Birthplace: Letcher Co., Ky.
Informant: Virgil TRIPLETT, Bevinsville, Ky.
Burial Place: Hi Hat, Ky.
Date: 12 January 1945
Signature of funeral director: W. J. Ryan, Martin, Ky.
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 11 January 1945
I hereby certify that I attended deceased from 10 January 1945 to
11 January 1945, that I last saw him alive on 11 January 1945,
and that death occurred on the date stated above at 4:30
Immediate cause of death: Body Burn
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. A. Stumbo, M.D., Martin, Ky.
Date signed: 03 February 1945
Transcribed by Debbie Tamborski, 06 June 2010 |
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