Date:  02 September 1953
Cert:  19130 
Place of Death: County: Knott      City or Town: Rural
Length of stay (in this place): (blank)
Street address or location:  Leburn, Ky.
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Rural    If rural give location: Leburn, Ky.
Full Name:  Jay JOHNSON 
Date of Death:  02 September 1953 
Sex, Color or Race, Marital Status:  Male, White, Married 
Date of Birth:  06 April 1904 
Age:   49 years
Usual Occupation:  Farm
Kind of Industry or business: Farming
Birthplace:  Knott Co., Ky. 
Father's Name:  Shade JOHNSON 
Mother's Maiden Name:  Roda CHILDERS 
Was deceased ever in armed forces: (blank)
Social Security No.:  (blank)
Informant:  Delmas JOHNSON 
Disease or condition directly leading to death: Pulmonary Tuberculosis
Interval between onset and death:  05 years
Due to:  (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 10 July 1950 to 30 August 1953, that I last saw the deceased alive on 30 August 1953, and that death occurred at 3:30 a.m., from the causes and on the date stated above.
Date signed:   02 September 1953
Address:  Hindman, Ky. 
Signature:  M. F. Kelley, M.D. 
Burial, Cremation or Removal:  Burial
Date:  04 September 1953 
Name of Cemetery or Crematory:  Family Cemetery
Location:  Leburn, Knott Co., Ky. 
Date received by local registrar:  14 September 1953 
Registrar's Signature:  Mrs. Rose B. Craft
Funeral director & address:  John N. Taul - Hindman, Ky.
Transcribed by Debbie Tamborski, 09 February 2011