Date: 28 November 1946
Cert: 26820
Place of Death: County: Knott City or
Town: Mallie, Ky. Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: 15 years
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Mallie Rural
Full Name: Catherine SHORT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Hiram SHORT
Age of husband or wife if alive: 53 years
Birth date of deceased: 08 July 1892
Age: 54 years, 04 months, 20 days
Birthplace: Hindman, Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Wesley SPARKMAN
Father Birthplace: Floyd Co., Ky.
Mother Maiden Name: Polly Ann CAMPBELL
Mother Birthplace: Letcher Co., Ky.
Informant: Hiram SHORT, Mallie, Ky.
Burial Place: Branham's Creek
Date: 01 December 1946
Signature of funeral director: None - Friends, Mallie,
Ky.
Date received by local registrar: 14 December 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 28 November 1946
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at 7 p.m.
Immediate cause of death: Heart Failure died sudden
Duration: (blank)
Due to: Rheumatism
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: J. W. Duke, M.D., Hindman, Ky.
Date signed: 14 December 1946
Transcribed by Debbie Tamborski, 15 December 2010 |