Date: 29 September 1946
Cert: 26822
Place of Death: County: Knott City or
Town: Pippapass, Ky. Rural
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: Pippapass
Full Name: Charlie SHORT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White,
Married
Husband or Wife of: Liza Jane SHORT
Age of husband or wife if alive: 70 years
Birth date of deceased: (blank)
Age: 73 years
Birthplace: Knott
Occupation: Farmer
Industry or business: (blank)
Father Name: Wilson SHORT
Father Birthplace: Knott
Mother Maiden Name: Nancy SLOAN
Mother Birthplace: Knott
Informant: Nancy OWENS, Pippapass
Burial Place: Short Cem.
Date: 30 September 1946
Signature of funeral director: Engle's, Hazard, Ky.
Date received by local registrar: 16 December 1946
Registrar's Signature: Rose B. Craft
Date of Death: 29 September 1946
I hereby certify that I attended deceased from 01 September
1946 to
29 September 1946, that I last saw him alive on 10 September
1946, and that death occurred on the date stated above at 9
p.m.
Immediate cause of death: Disease heart and appoplexia
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: 16 December 1946
Transcribed by Debbie Tamborski, 15 December 2010 |