Death Certificate of Mary Jane Bolton 1948

Transcription & photocopy Submitted by Mitzi Freeman March 27, 2002
e-mail address: SETraveler@tngenes.net

Certificate of Death
Certificate: 5969
Place of Death: Knox
City: Rural
Usual Residence of Deceased
State: KY
County: Knox
City: Rural
Street: Rorsland
Full Name: Mary Jane Bolton
Sex: Female
Color Race: White
Single, Married, Widowed, or Divorced: Widow
Date of Birth: Aug 28
Age: 75 yrs  mos  ds
Birth Place: Laurel Ky
Name of Father: Jack Thompson
Birth Place of Father: Ky
Maiden Name of Mother: Louisa Chance
Birth Place of Mother: Ky
Informant: Tom Blanton
Address: Gray, KY
Burial, Cremation, or Removal: Grays, KY
Date: 3-18-1948
Funeral Director: B. W. Kinaird
Address: Corbin, KY
Date Received by Registrar: 3-27-48
Registrar: Bessie McDonald
Date of Death: March 15, 1948
I hereby certify that I attended deceased from Mch 14, 1948 to Mch 15, 1948
that I saw her alive on Mch 14, 1948 that death occurred, on the date
stated above, at 5pm.
The cause of death was as follows: organic valvular heart
Contributory:
Signature: W. H. Jones, MD
Address: Gray
Dated Signed: Mch 17, 1948

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