Date: 24 April 1952
Cert: 10455
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Vest, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Vest, Ky.
Full Name: Polly SMITH FUGATE
Date of Death: 24 April 1952
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 24 June 1860
Age: 91 years
Usual Occupation: Housewife
Kind of Industry or business: Keeping house
Birthplace: Perry County, Ky.
Father's Name: Isaac SMITH
Mother's Maiden Name: Sitha STACY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Daniel FUGATE
Disease or condition directly leading to death: Senility
Interval between onset and death: (blank)
Due to: The Person never had a doctor in her life.
Other significant conditions: (blank)
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 10:45 p.m., from the causes and on the
date stated above.
Date signed: 24 April 1952
Address: Hindman, Ky.
Signature: J. N. Taul (Coroner)
Burial, Cremation or Removal: Burial
Date: 26 April 1952
Name of Cemetery or Crematory: Fugate Cemetery
Location: (Ball), Perry, Ky.
Date received by local registrar: 16 May 1952
Registrar's Signature: Rose B. Craft
Funeral director & address: John N. Taul, Hindman
Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 24 January 2011 |