Date:  12 October 1949
Cert:  23447 
Place of Death: County: Knott Co.   City or Town: Rural  Smithsboro
Length of stay (in this place): 10 years
Name of Hospital or Institution:  Smithsboro, Ky
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: (blank)      Street Address: (blank)
Full Name:  Tobe ADAMS
Date of Death:  12 October 1949
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  (blank)
Age:  76 years
Usual Occupation:  (blank)
Kind of Industry or business: Black Smith
Birthplace:  Letcher Co., Ky.
Father's Name:  Randolph ADAMS
Mother's Maiden Name:  Elizabeth CALHOUN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  Clark ADAMS
Disease condition directly leading to death: Acute Heart Failure
Interval between onset and death:  (blank)
Due to:  (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy:  No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 12 October 1949 to 12 October 1949, that I last saw the deceased alive on 12 October 1949, and that death occurred at 1 p.m., from the causes and on the date stated above.
Date signed:  21 October 1949
Address:  Allock
Signature:  A. B. Pigman, M.D.
Burial, Cremation or Removal:  Burial
Date:  14 October 1949
Name of Cemetery or Crematory:  Cornett Hill
Location:  Sassafras, Ky.
Date received by local registrar: 01 April 1949
Registrar's Signature:  Georgia Pendleton
Funeral director & address:  Maggard & Garrett, Hazard, Ky.
Transcribed by Debbie Tamborski, 02 January 2011