Date:  19 June 1952
Cert:  15202 
Place of Death: County: Knott      City or Town: Rural
Length of stay (in this place): All of life
Street address or location:  Larkslane, Ky.
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Rural     Street Address: Larkslane, Ky.
Full Name:  Katie JACOBS
Date of Death:  19 June 1952
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth:  unknown
Age:  app. 70 years
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace:  Knott Co., Ky.
Father's Name:  Bob SLONE
Mother's Maiden Name:  Katherine SLONE
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant:  Columbus JACOBS
Disease or condition directly leading to death:  Cardiac failure
Interval between onset and death:  (blank)
Due to:  Heart & age
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy:  (blank)
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 (blank), from the causes and on the date stated above.
Date signed:  20 June 1952
Address:  Hindman, Ky.
Signature:  Jno. N. Taul, Coroner
Burial, Cremation or Removal:  Burial
Date:  23 June 1952
Name of Cemetery or Crematory:  Jacobs Cemetery
Location:  Pippapass, Ky.
Date received by local registrar: 25 June1952
Registrar's Signature:  Rose B. Craft
Funeral director & address:  Jno. N. Taul, Hindman, Ky.
Transcribed by Debbie Tamborski, 26 January 2011