Date: 12 August 1945
Cert: 21789
Place of Death: County: Knott City or
Town: Smithsboro, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: 04
years, 04 months, 23 days
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Smithsboro Rural
Full Name: Noah FRANCIS
If Veteran Name War: (blank)
Social Security No.: 403-10-1426
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 11 March 1905
Age: 40 years, 05 months, 01 days
Birthplace: Smithsboro, Ky.
Occupation: Mining
Industry or business: Mining
Father Name: G. W. FRANCIS
Father Birthplace: Smithsboro
Mother Maiden Name: Melvina SMITH
Mother Birthplace: Smithsboro, Ky.
Informant: John Wheeler (illegible ?Witt?),
Smithsboro, Ky.
Burial Place: Smithsboro
Date: 12 August 1945
Signature of funeral director: Friends & neighbors,
Smithsboro
Date received by local registrar: 24 October 1945
Registrar's Signature: Rose B. Craft
Date of Death: 12 August 1945
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: Hemorrhage of lungs
Duration: (blank)
Due to: Pulmonary tuberculosis
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: 22 October 1945
Transcribed by Debbie Tamborski, 27 November 2010 |