Date:    27 March 1947
Cert:    29177 
Place of Death: County: Knott    City or Town:  Mallie, Knott Co., Ky.
Street Number or Location:  Rural
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town:  Mallie     Rural 
Full Name:  Arnon J. JACOBS 
If Veteran Name War: (blank)
Social Security No.:  (blank)
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:  27 March 1947 
Age:  04 hours
Birthplace:  Mallie, Knott Co., Ky. 
Occupation:  None - Infant 
Industry or business:  (blank)
Father Name:  Walter JACOBS 
Father Birthplace:  Knott Co., Ky. 
Mother Maiden Name:   Tona SHORT 
Mother Birthplace:   Knott Co., Ky. 
Informant:   Tonie SHORT JACOBS, Mallie, Ky. 
Burial Place:   Mallie, Ky. 
Date:  28 March 1947 
Signature of funeral director:  None - Friends, Mallie, Ky.
Date received by local registrar:  Completed 09 December 1948
Registrar's Signature: Rose B. Craft
Date of Death:  27 March 1947 
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:  Premature Birth.  I did not attend this birth, but according to information received through correspondence (attached) this statement must be correct
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:  Birth attended by Frankie J. Reynolds, J. W. Duke, M.D., Hindman
Date signed: 09 December 1948
(Transcriber's note: Written at bottom of page Birth reported April 1947)
Transcribed by Debbie Tamborski, 18 December 2010