Date:  29 May 1954
Cert:  #16284
Place of Death: County: Knott  City or Town: Lackey, Ky. Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: Stumbo Memorial Hospital
Usual Residence of Deceased: State: Kentucky    County: Knott
City or Town: Lackey Rural     Street Address: on Jones' Fork
Full Name:  Jerome SCOTT
Date of Death:  29 May 1954
Sex, Color or Race, Marital Status: Male, White, Infant
Date of Birth:  16 May 1954
Age: 13 days
Usual Occupation: None - Infant
Kind of Industry or business: None
Birthplace:  Stumbo Hosp. - Knott Co., Ky.
Father's Name:  Arthur SCOTT
Mother's Maiden Name:  Ethel Mae GIBSON
Was deceased ever in armed forces: no
Social Security No.:  none
Informant:  none (Mother) Mrs. Ethel M. G. SCOTT
Disease or condition directly leading to death:  Blood disease  M.D. said White cells destroyed the Red Cells - Impossible to save baby
Interval between onset and death:  13 days
Due to:  Blood disease as described above
Other significant conditions: (blank)
Date of Operation: no operation performed
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: None - Died natural death
Place of injury: about home
City or Town, County, State: Lackey, Knott, Kentucky
Time of Injury: 29 May 1954
Injury occurred at work: not while at work
How did injury occur: Unknown
I hereby certify that I attended deceased from 16 May 1954 to 29 May 1954, that I last saw the deceased alive on 28 May 1954, and that death occurred at 7:00 p.m., from the causes and on the date stated above.
Date signed:  01 July 1954
Address:  Lackey, Ky.
Signature:  C. Wicker, M.D.
Burial, Cremation or Removal: Burial
Date:  02 June 1954
Name of Cemetery or Crematory: Family Cemetery
Location:  Lackey, Knott, Kentucky
Date received by local registrar:  02 July 1954
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address:  Friends & Neighbors - Lackey, Ky.
Transcribed by Debbie Tamborski, 17 March 2011