Date: 04 September 1952
Cert: 21722
Place of Death: County: Knott
City or Town: Littcarr
Length of stay (in this place): All of life
Street address or location: Littcarr, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Littcarr, Ky.
Full Name: Ambrose B. SMITH
Date of Death: 04 September 1952
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 25 January 1885
Age: 67 years
Usual Occupation: Miner
Kind of Industry or business: Coal Mining
Birthplace: Knott Co., Ky.
Father's Name: Ambrose SMITH
Mother's Maiden Name: Rebecca SMITH
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Ambrose B. SMITH
Disease or condition directly leading to death:
Pulmonary Tuberculosis
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 (blank), from the causes and on the
date stated above.
Date signed: 08 September 1952
Address: Hindman, Ky.
Signature: J. W. Duke, M.D.
Burial, Cremation or Removal: Burial
Date: 07 September 1952
Name of Cemetery or Crematory: Family Cemetery
Location: Littcarr, Ky.
Date received by local registrar: 15 September 1952
Registrar's Signature: Rose B. Craft
Funeral director & address: John N. Taul, Hindman,
Ky.
Transcribed by Debbie Tamborski, 28 January 2011 |