Date: 10 September 1944
Cert: 01596
Place of Death: County: Knott City or
Town: Lackey Rural
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Hollybush, Ky.
Full Name: William TRIPLETT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, (blank)
Husband or Wife of: William TRIPLETT (transcribed as written)
Age of husband or wife if alive: forty years
Birth date of deceased: 18 July 1874
Age: 70 years, 01 months, 23 days
Birthplace: Hollybush
Occupation: Farming
Industry or business: (blank)
Father Name: Wilson TRIPLETT
Father Birthplace: Hollybush
Mother Maiden Name: Cordelia TRIPLETT
Mother Birthplace: Hollybush
Informant: Layunia TRIPLETT, Hollybush, Ky.
Burial Place: Hollybush
Date: 12 September 1944
Signature of funeral director: None
Date received by local registrar: 21 January 1945
Registrar's Signature: Ida Livingston Rose B. Craft
Acting Reg.
Date of Death: 10 September 1944
I hereby certify that I attended deceased from 09 September
1944 to
10 September 1944, that I last saw him alive on 10 September
1944, and that death
occurred on the date stated above at (blank)
Immediate cause of death: Peritonitis
Duration: (blank)
Due to: Abscess gland (illegible)
Major findings of operations: Peritonitis
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. R. Hodge, M.D., Lackey, Ky.
Date signed: 24 January 1945
Transcribed by Debbie Tamborski, 26 November 2010 |