Date:   23 November 1943
Cert:   27681
Place of Death: County: Knott     City or Town: Mousie, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Mousie, Ky.
Full Name:  Lawrence WALLEN
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of:  Edna SPARKMAN
Age of husband or wife if alive:  21 years
Birth date of deceased:  03 November 1919
Age: 24 years, 17 days
Birthplace:  Mousie, Ky.
Occupation:  Farmer
Industry or business: (blank)
Father Name:  Cisero WALLEN
Father Birthplace:  Mousie, Ky.
Mother Maiden Name:  Martha SMITH
Mother Birthplace:  Elmrock, Ky.
Informant:  Cisero WALLEN, Mousie, Ky.
Burial Place:  Campbell Cem.
Date:  24 November 1943
Signature of funeral director: (blank)
Date received by local registrar:  (blank)
Registrar's Signature:  (blank)
Date of Death: 23 November 1943
I hereby certify that I attended deceased from (blank) to 23 November 1943, that I last saw him alive on 20 November 1943, and that death occurred on the date stated above at 10 a.m.
Immediate cause of death: Pulmonary T. B.
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. W. Duke, M.D., Hindman
Date signed:  27 November 1943
Transcribed by Debbie Tamborski, 29 October 2010