Date:  04 May 1955
Cert:  #9986
Place of Death: County: Knott      City or Town: Hindman
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town: Carrie - Rural     Street Address: (blank)
Full Name:  Charley CLEMONS
Date of Death:  04 May 1955
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth:  13 September 1905
Age: 49 years
Usual Occupation:  Retired
Kind of Industry or business: Soldier
Birthplace:  Hardberly, Ky.
Father's Name:  Ell Caney CLEMONS
Mother's Maiden Name:  America FUGATE
Was deceased ever in armed forces: Yes
Social Security No.: (blank)
Informant:  Mrs. Charley CLEMONS 
Disease/condition directly leading to death: Coronary Thrombosis
Interval between onset and death: 10 minutes
Due to:  Coronary artery disease
Interval between onset and death:  07 years
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
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 06 May 1948 to 04 May 1955, that I last saw the deceased alive on 04 May 1955, and that death occurred at 10:44 a.m., from the causes and on the date stated above.
Date signed:  13 May 1955
Address:  Hindman, Ky.
Signature:  D. G. Barker, M.D.
Burial, Cremation or Removal: Burial
Date:  06 May 1955
Name of Cemetery or Crematory:  Fugate Cemetery
Location:  Carrie, Ky.
Date received by local registrar: 13 May 1955
Registrar's Signature: Myrtle Slone
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 14 May 2011