Date:  26 September 1953
Cert:  27433 
Place of Death: County: Knott      City or Town: Mousie
Length of stay (in this place): 05 years
Name of Hospital or Institution:  (blank)
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town: Mousie    If rural give location: (blank)
Full Name:  Barbara PACK 
Date of Death:  26 September 1953 
Sex, Color or Race, Marital Status: Female, White, Widowed 
Date of Birth:  18 October 1879 
Age:   73 years 
Usual Occupation:  Housewife
Kind of Industry or business: Home
Birthplace:  Virginia 
Father's Name:  T. J. SHREVE 
Mother's Maiden Name:  ALICE SHIPLEY 
Was deceased ever in armed forces: (blank)
Social Security No.:  (blank)
Informant:  Mrs. C. D. FRANCIS 
Disease/condition directly leading to death: Coronary Occlusion
Interval between onset and death:  Diabetes Mellitus
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 10 December 1952 to 25 September 1953, that I last saw the deceased alive on 25 September 1953, and that death occurred at 2:00 a.m., from the causes and on the date stated above.
Date signed:  28 September 1953
Address:  Garrett, Ky.
Signature:  G. B. Ison, M.D.
Burial, Cremation or Removal: Burial
Date:  28 September 1953
Name of Cemetery or Crematory: Tom Martin Cemetery
Location:  Garrett, Ky.
Date received by local registrar: 29 December 1953
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address:  Charles L. Hornsby, Hindman, Ky.
Transcribed by Debbie Tamborski, 10 February 2011