Date: 15 March 1946
Cert: 11626
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: Kentucky
County: Knott
City or Town: Pippapass Rural
Full Name: Pearl SHORT
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Lula RICHARDSON SHORT
Age of husband or wife if alive: 37 years
Birth date of deceased: 01 April 1902
Age: 43 years
Birthplace: Pippapass
Occupation: Farmer
Industry or business: (blank)
Father Name: Charley SHORT
Father Birthplace: Pippapass, Ky.
Mother Maiden Name: Susie STURGILL
Mother Birthplace: Pike Co., Ky.
Informant: Lula SHORT, Pippapass, Ky.
Burial Place: Pippapass, Ky.
Date: 17 March 1946
Signature of funeral director: None
Date received by local registrar: 31 May 1946
Registrar's Signature: Mrs. Rose B. Craft
Date of Death: 15 March 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 (blank)
Immediate cause of death: Mitral Stenosis
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: 31 May 1946
Transcribed by Debbie Tamborski, 15 December 2010 |