Date:   21 January 1942
Cert:   01761 
Place of Death: County: Knott     City or Town: Lackey, Ky.
Name of Hospital or Institution: Stumbo Memorial Hospital
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.   County: Breathitt Co.
City or Town:  (blank)
Full Name:  Carie DAVIDSON
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  06 July 1927
Age: 14 years, 06 months, 15 days
Birthplace:  Jackson, Ky.
Occupation:  (blank)
Industry or business: (blank)
Father Name:  John DAVIDSON
Father Birthplace:  Knott Co.
Mother Maiden Name:  Caldona BARNETT
Mother Birthplace:  Jackson
Informant:  Wm. DAVIDSON, Hueysville, Ky.
Burial Place:  Pourthmouth, Ky.
Date:  22 January 1942
Signature of funeral director: O. T. Lemaster, Martin, Ky.
Date received by local registrar:  05 February 1942
Registrar's Signature:  Ida Livingston
Date of Death:  21 January 1942
I hereby certify that I attended deceased from 20 January 1942 to 21 January 1942, that I last saw her alive on 21 January 1942, and that death occurred on the date stated above at 7:30 a.m.
Immediate cause of death:  encephalitis
Duration: 02 weeks
Due to: Measles
Duration:  06 weeks
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: C. R. Messer, M.D., Lackey, Ky.
Date signed:  04 February 1942
Transcribed by Debbie Tamborski, 17 October 2010