Date: 07 December 1944
Cert: 13011
Place of Death: County: Knott City or
Town: De Coy (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: Decoy (rural)
Full Name: Andrew B. SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of: Mahala STACY SMITH
Age of husband or wife if alive: 71 years
Birth date of deceased: Unknown
Age: 77 years
Birthplace: Perry County, Ky.
Occupation: Farmer
Industry or business: (blank)
Father Name: Richard SMITH
Father Birthplace: Kentucky
Mother Maiden Name: Frankie MILLER
Mother Birthplace: Kentucky
Informant: Jerry SMITH, De Coy, Kentucky
Burial Place: De Coy, Ky.
Date: 09 December 1944
Signature of funeral director: none
Date received by local registrar: (blank)
Registrar's Signature: (blank)
Date of Death: 07 December 1944
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: Apoplexy
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: J. W. Duke, M.D., Hindman, Ky.
Date signed: 22 March 1945
Transcribed by Debbie Tamborski, 22 November 2010 |