Date: 07 May 1947
Cert: 16050
Place of Death: County: Knott City or
Town: Rural Anco, Ky.
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: Anco Street No.:
Rural
Full Name: Dicy SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Joe SMITH
Age of husband or wife if alive: 81 years
Birth date of deceased: not known
Age: 84 years
Birthplace: Perry Co., Ky.
Occupation: Housewife
Industry or business: (blank)
Father Name: Lewis MORRIS
Father Birthplace: Perry Co.
Mother Maiden Name: -- OLIVER
Mother Birthplace: Ky.
Informant: Dan WHITE, Anco, Ky.
Burial Place: Chavies
Date: 08 May 1947
Signature of funeral director: Maggard & Blair, by R. E.
Cox, Hazard
Date received by local registrar: 30 July 1947
Registrar's Signature: Rose B. Craft
Date of Death: 07 May 1947
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 10 a.m.
Immediate cause of death: Appoplexy
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. R. Aker, M.D., Anco, Ky.
Date signed: (blank)
Transcribed by Debbie Tamborski, 20 December 2010 |