DEATH CERTIFICATE: CRISP, DOLLIE (STEPHENS) 1877-1950
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Submitted:September 12, 2003
Submitter:Sherri Hall
          ldrbelties@earthlink.net
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Original Death Certificate can be viewed at:
http://www.usgwarchives.net/ky/floyd/deaths/dcrisp.jpg

Transcribd by:Cheryl Burton Bokisa
              Cherbok@msn.com

Commonwealth of Kentucky; Certificate of Death
State file no. 50 7091
Registrar's no. 76
Registration District no. 520
Primary Registration District no. 5251

1. Place of Death
a. County: Floyd
b. City/Town: Martin, KY
c. Length of Stay (in this place): 01
d. Full Name of Hospital/Institution: Our Lady of the Way

2. Usual Residence:
a. State: KY
b. County: Floyd
c. City/Town: Martin, KY
d. Street Address: Blank

3. Name of Deceased:
a. First: Dollie
b. Middle (Maiden): Stephens
c. Last: Crisp

4. Date of Death:
a. Month: March (3)
b. Day: 31
c. Year: 1950

5. Sex: Female
6. Color/Race: White
7. Marital Status: Widowed
8. Date of Birth: 12-16-1877
9. Age (in years at last birthday): 72
10a. Usual Occupation: Blank
10b. Kind of Business/Industry: Domestic
11. Birthplace: Alphoretta, Floyd County, KY
12. Citizen of What Country: Blank
13. Father's Name: William Stephens
14. Mother's Maiden Name: Rebecca Bradley
15. Was Deceased in US Armed Forces: Blank
16. Social Security Number: Blank
17. Informant: Joe Hughes
18. Cause of Death:
a. Disease/Condition Directly Relating to Death:
   Cerebral Thrombosis 10 days
b. Antecedent Causes: Senility; Arteriosclorotic Disease
c. Due to: Blank
d. Other Significant Conditions: Blank
19a. Date of Operation: Blank
19b. Major Findings of Operation: 332x-070-16
20. Autopsy: No
21a. Accident/Suicide/Homicide: Blank
21b. Place of Injury: Blank
21c. City/Town Injury: Blank
21d. Time of Injury: Blank
21e. Injury Occurred: Blank
21f. How Injury Occurred Work/Not: Blank
22. Physician attended deceased from 3-25-1950 to 
Mar. 31, 1950; Last saw alive 3-30-1950 & Death occurred
9:15 am, From Cause of Death Stated Above.
23a. Date signed: April 15, 1950
23b. Address: martin
23c. Signature of Physician: See Original
24a. Burial
24b. Date of Burial: April 2, 1950
24c. Place of Burial: Hampton Cemetery
24d. Location of Burial: Martin, Floyd County, KY
25a. Date received by local registrar: April 18, 1950
25b. Registrar's Signature: See Original
26. General Director: Signature & Address See Original

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