Date:   08 November 1942
Cert:   27292 
Place of Death: County: Knott Co.  City or Town: Pippapass
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:  Dalley SHORT Child
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White
Husband or Wife of:  Haze SHORT age 27
Age of husband or wife if alive:  Elsie SHORT 22
Birth date of deceased:  06 December 1941
Age: 11 months, 02 days
Birthplace:  Pippapass
Occupation:  Farmer
Industry or business: (blank)
Father Name:  Haze SHORT
Father Birthplace:  Pippapass, Ky.
Mother Maiden Name:  Elsie SLONE
Mother Birthplace:  Garner, Ky.
Informant:  (blank)
Burial Place:  Short Fork Semitary
Date:  09 November 1942
Signature of funeral director:  (blank)
Date received by local registrar:  02 December 1942
Registrar's Signature: Ida Livingston
Date of Death:  08 November 1942
I hereby certify that I attended deceased from 1942 to (blank), that I last saw him alive on (blank), and that death occurred on the date stated above at 12 p.m.
Immediate cause of death:  Hart
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: Eliza J. Short, Mallie, Ky.
Date signed:  14 November 1942
Transcribed by Debbie Tamborski, 16 October 2010