Date:   22 September 1943
Cert:   15297 
Place of Death: County: Knott     City or Town: Ritchie
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Ritchie
Full Name:  Boone SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White
Husband or Wife of:  (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased:  (blank)
Age: about 45 years
Birthplace:  (blank)
Occupation:  (blank)
Industry or business:  (blank)
Father Name:  (blank)
Father Birthplace:  (blank)
Mother Maiden Name:  (blank)
Mother Birthplace:  (blank)
Informant:  Sam SMITH, Ary, Ky.
Burial Place:  (blank)
Date:  (blank)
Signature of funeral director: Engles, Hazard, sold material, Family burial
Date received by local registrar: 10 April 1945
Registrar's Signature:  Mrs. Rose B. Craft, Acting, Per B. Carns
Date of Death:  22 September 1943
I hereby certify that I attended deceased from 10 July 1943 to 01 September 1943, that I last saw him alive on (blank), and that death occurred on the date stated above at (blank)
Immediate cause of death: Pulmonary Tuberculosis
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: S. M. Richie, M.D., Hazard, Ky.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 27 October 2010