Date: 10 February 1947
Cert: 09218
Place of Death: County: Knott City or
Town: Rural
Street Number or Location: Spider, Ky.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural
give precinct: Spider
Full Name: Elizabeth MORRIS SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White,
Married
Husband or Wife of: Jesse B. SMITH
Age of husband or wife if alive: 72 years
Birth date of deceased: 04 May 1883
Age: 63 years, 09 months, 06 days
Birthplace: Lee Co., Va.
Occupation: House Keeper
Industry or business: (blank)
Father Name: Dr. Frank MORRIS
Father Birthplace: Va.
Mother Maiden Name: Martha PHILLIPS
Mother Birthplace: Ashville, N.C.
Informant: Jessie B. SMITH, Spider, Ky.
Burial Place: Hindman
Date: 13 February 1947
Signature of funeral director: Joe Greer, Hazard, Ky.
Date received by local registrar: 25 March 1947
Registrar's Signature: Rose B. Craft
Date of Death: 10 February 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 (blank)
Immediate cause of death: Acute indigestion and heart
failure
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: 30 April 1947
Transcribed by Debbie Tamborski, 20 December 2010 |