Date: 13 March 1943
Cert: 09342
Place of Death: County: Knott City or
Town: Rural
Street No. or Location: Smithsboro, Ky.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural
Full Name: Amanda ELAM
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Jackson ELAM
Age of husband or wife if alive: 69 years
Birth date of deceased: (blank)
Age: 63 years
Birthplace: Knott Co.
Occupation: Housekeeper
Industry or business: (blank)
Father Name: (blank)
Father Birthplace: (blank)
Mother Maiden Name: (blank)
Mother Birthplace: (blank)
Informant: Ira COMBS, Smithsboro, Ky.
Burial Place: Smithsboro
Date: 14 March 1943
Signature of funeral director: Engle Und. & Hdwe., Hazard, Ky.
Date received by local registrar: 31 March 1943
Registrar's Signature: Ida Livingston
Date of Death: 13 March 1943
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Apoplexy
Duration: (blank)
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: J. R. Aker, M.D., Anco, Ky.
Date signed: 25 March 1943
Transcribed by Debbie Tamborski, 23 October 2010 |