Date:    04 August 1947
Cert:    22634 
Place of Death: County: Knott   City or Town:  Hindman, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Hindman     Rural 
Full Name:  Carl ROBERTS 
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:   04 August 1947
Age:  05 hours
Birthplace:  Knott Co., Ky. 
Occupation:  None 
Industry or business:  (blank)
Father Name:  Vester ROBERTS 
Father Birthplace:  Knott Co., Ky. 
Mother Maiden Name:   Edith JONES 
Mother Birthplace:   Perry Co., Ky. 
Informant:  Vester ROBERTS, Hindman, Ky. 
Burial Place:   Roberts Cemty. 
Date:  05 August 1947 
Signature of funeral director:  Friends, Hindman
Date received by local registrar:  11 October 1947 
Registrar's Signature:  Rose B. Craft
Date of Death:  04 August 1947 
I hereby certify that I attended deceased from 04 August 1947 to 04 August 1947, that I last saw him alive on 04 August 1947, and that death occurred on the date stated above at 8 p.m.
Immediate cause of death:  Don't know 
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:  M. F. Kelley, M.D., Hindman, Ky.
Date signed:  11 October 1947 
Transcribed by Debbie Tamborski, 20 December 2010