Date:  02 November 1954
Cert:  22401 
Place of Death: County: Knott      City or Town: Kite
Length of stay (in this place): (blank)
Name of Hospital or Institution:  (blank)
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town:  Kite    If rural give location: (blank)
Full Name:  Columbus BATES 
Date of Death:  02 November 1954 
Sex, Color or Race, Marital Status:  Male, White, Married
Date of Birth:  15 September 1913 
Age:  41 years 
Usual Occupation:  Miner
Kind of Industry or business: Coal Mines
Birthplace:   Knott Co., Ky. 
Father's Name:  Joe BATES 
Mother's Maiden Name:  Mary Alice VANOVER 
Was deceased ever in armed forces: (blank)
Social Security No.:  (blank)
Informant:  (blank)
Disease or condition directly leading to death: (illegible) carcinoma of lung
Interval between onset and death:  07 months
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 23 July 1954 to 01 October 1954, that I last saw the deceased alive on 01 October 1954, and that death occurred at (blank), from the causes and on the date stated above.
Date signed: 05 November 1954
Address:  Lackey, Kentucky
Signature:  Charles L. Roach, M.D.
Burial, Cremation or Removal: Burial
Date:  04 November 1954
Name of Cemetery or Crematory: Greasy Burgey Cemetery
Location:  May, Ky. 
Date received by local registrar:  05 November 1954
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 23 February 2011