Date: 02 June 1950
Cert: 18773
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Brinkley, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Brinkley, Ky.
Full Name: Alice SMITH
Date of Death: 02 June 1950
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 14 October 1872
Age: 77 years
Usual Occupation: Housewife
Kind of Industry or business: Keeping House
Birthplace: Knott Co., Ky.
Father's Name: William B. SMITH
Mother's Maiden Name: Susan HAMILTON
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Kermit SMITH
Disease or condition directly leading to death: Cancer
Interval between onset and death: years
Due to: (blank)
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 (blank) to
(blank), that I last saw the deceased alive on (blank), and
that death occurred at 9 a.m., from the causes and on the
date stated above.
Date signed: 14 September 1950
Address: Hindman, Ky.
Signature: J. W. Duke
Burial, Cremation or Removal: Burial
Date: 03 June 1950
Name of Cemetery or Crematory: Family Cem.
Location: Brinkley, Ky. (Knott Co.)
Date received by local registrar: 07 June 1950
Registrar's Signature: Rose B. Craft
Funeral director/address: Hindman Funeral Home, Hindman, Ky.
Transcribed by Debbie Tamborski, 17 January 2011 |