DEATH Certificate: Mary Ellen Rock, 1863-1945, Ohio Co., KY

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Transcribed by:  Connie D. Hurley - ConnieDHurley1@webtv.net
Date: 12 Sept 1999 
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Mary Ellen Kinkade Rock
Certificate Of Death
State File    17813
Registered No.133
Registered Distrct No. 1125
Primary Registered No. 7611
1-Place Of Death
a) County        Ohio
b) City or Town      Cromwell Ky
c)Name of Hospital or Instution
        None
d)Length Of Stay In Hospital Or Instution
      None
2)Usual Residence of Deceased
a) State     Ky
b)County    Ohio
c) City or Town      Beaverdam
d)Street
e) If foreigh born or in U.S.A
U.S.A
3) (3 A)Full Name
   Mary Ellen Kinkade Rock
3 (b) If Vetern
  No
3)(c) Social Security No.     
No
4) Sex     Female
5)Color or Race
White
6) Single  Widowed  Married  Divorced
            Widowed
6) (b) Name of Husband or Wife
Shelby Rock
6) (c) Age of Husband or Wife if Alive
Deceased    June    1945
7) Birth Date of Deceased
Month    Oct.     Day    8   Year    1863
8) Age  81 yrs   10  Months  2 Days
9)Birthplace      Ind.
10) Usual Occupation   Houewife
11)Indutry or Business
12) Name of Father
John Kinkade
13) Brthplace   Tenn
14)Maiden Name of Mother
Lou  Cole
15) Birthplace    Indiana
16)(a) Informant own signature
Mrs. Dona ? Martin
(b) Address    Beaverdam Ky
17)Burila , Creamation or Burial
Place       Liberty
Date       8   11   1945 
18)(a) Signature of Funeral Director
? L. Caseber
(b) Address      BeaverDam Ky
19)(a) Date Recieved by Local Registrar's
8 - 28-45
9(b) Registrar's  Signature
Bessie L. Hunley
20)  Medical Certification
Date of Death     xxx 10   1945
21) I do Hereby cetifi that I attended the deceased   ~~~~~~~~~~~
That death did occurred on the date as stated above  at      9:30 p.m.
Immediate Cause of Death
~~~~~~~~~
Due to Heart Attack
Never saw this patient untill after death
22)
(a)
(b) 
(c)
23) Siginature   R.W. Kittinger
Address           Cromwell Ky
Date Signed      8 - 25-1945