Date: 20 March 1956
Cert: #56-14783
Place of Death: County: Knott
City or Town: Gunlock Rural
Length of stay (in this place): (blank)
Full Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky. County:
Knott
City or Town: Gunlock Street
Address: (blank)
Full Name: Ashford SMITH
Date of Death: 20 March 1956
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 07 April 1890
Age: 65 years
Usual Occupation: Farmer
Kind of Industry or business: (blank)
Birthplace: Ky.
Father's Name: Irvin SMITH
Mother's Maiden Name: Margaret BRADLEY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Claude SMITH
Disease/condition directly leading to death: Cerebral
Hemorrhage
Interval between onset and death: (blank)
Due to (b): Hypertension
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: (blank)
Address: (blank)
Signature: John J. Shearman, M.D.
Burial, Cremation or Removal: Burial
Date: 21 March 1956
Name of Cemetery or Crematory: Bailey
Location: Gunlock, Ky.
Date received by local registrar: 24 July 1956
Registrar's Signature: Myrtle Slone
Funeral director & address: B. C. Hall, Martin, Ky.
Transcribed by Debbie Tamborski, 04 April 2012 |