Date: 05 May 1950
Cert: 10348
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): 08 years
Street address or location: Bath, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Bath, Ky.
Full Name: Alfred SMITH
Date of Death: 05 May 1950
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: unknown
Age: app. 80 years
Usual Occupation: Farmer
Kind of Industry or business: Farming
Birthplace: Morgan Co., Ky.
Father's Name: Hiram SMITH
Mother's Maiden Name: Polly LEWIS
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Rachel SMITH
Disease or condition directly leading to death: Chronic
Nephritis
Interval between onset and death: (blank)
Due to: Kidney Disease
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 20 April 1950 to
05 May 1950, that I last saw the deceased alive on 03 May 1950, and
that death occurred at 2 p.m., from the causes and on the
date stated above.
Date signed: 18 May 1950
Address: Hindman, Ky.
Signature: M. F. Kelley
Burial, Cremation or Removal: Burial
Date: 07 May 1950
Name of Cemetery or Crematory: Family
Location: Bath, Ky.
Date received by local registrar: 18 May 1950
Registrar's Signature: Rose B. Craft
Funeral director & address: Hindman Funeral Home J. N.
Taul
Transcribed by Debbie Tamborski, 17 January 2011 |