Date:  03 September 1952
Cert:  21721 
Place of Death: County: Knott      City or Town: Lackey  Rural
Length of stay (in this place): 02 days
Name of Hospital or Institution:  Stumbo Hospital
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Rural     If rural give precinct:  Larkslane, Ky.
Full Name:  Devoe JACOBS
Date of Death:  03 September 1952
Sex, Color or Race, Marital Status: Male, White, Never Married
Date of Birth:  28 August 1952
Age:  06 days
Usual Occupation:  none
Kind of Industry or business: none
Birthplace:  Knott Co., Ky.
Father's Name:  I. B. JACOBS
Mother's Maiden Name:  Della CAUDILL
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  I. B. JACOBS
Disease/condition directly leading to death: Cause undetermined
Interval between onset and death:  (blank)
Due to:  (blank)
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 03 September 1952 to 03 September 1952, that I last saw the deceased alive on 03 September 1952, and that death occurred at 12:00 p.m., from the causes and on the date stated above.
Date signed:  04 September 1952
Address:  Lackey, Ky.
Signature:  C. M. Aker, M.D.
Burial, Cremation or Removal:  Burial
Date:  04 September 1952
Name of Cemetery or Crematory:  Hollybush Cemetery
Location:  Knott Co., Ky.
Date received by local registrar: 06 October 1952
Registrar's Signature:  Rose B. Craft
Funeral director & address:  John N. Taul, Hindman, Ky.
Transcribed by Debbie Tamborski, 26 January 2011