DEATH CERTIFICATE

AMERICA CLEMONS

Date:  07 January 1950
Cert:  01124 
Place of Death: County: Knott      City or Town:  Rural
Length of stay (in this place): All of life
Street address or location:  Carrie, Ky.
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town:  Rural     If rural give precinct:  Carrie, Ky.
Full Name:  America CLEMONS
Date of Death:  07 January 1950
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth:  04 April 1866
Age:  83 years
Usual Occupation: Housekeeper
Kind of Industry or business:  Keeping house
Birthplace:  Knott Co., Ky.
Father's Name:  Charlie FUGATE
Mother's Maiden Name:  Nancy HUDSON
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  Charlie CLEMONS
Disease or condition directly leading to death:  (blank)
Interval between onset and death:  (blank)
Due to:  (blank)
Other significant conditions: Heart Condition this person was found dead in a field.  After talking with the Dr. when had cared for her The Coroner jury, gave heart condition.
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 (blank) to (blank), that I last saw the deceased alive on (blank), and that death occurred at 7 p.m., from the causes and on the date stated above.  07 January 1950
Date signed:  10 January 1950
Address:  Hindman, Ky.
Signature:  J. N. Taul, Coroner
Burial, Cremation or Removal:  Burial
Date:  11 Janaury 1950
Name of Cemetery or Crematory:  Family
Location:  Carrie, Ky.
Date received by local registrar:  18 January 1950
Registrar's Signature:  Rose B. Craft 
Funeral director/address: Hindman Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 12 January 2011