Date:  24 April 1956
Cert: #56-10395
Place of Death: County: Knott      City or Town: Rural
Length of stay (in this place): (blank)
Street Address or Location:  Shoftshell (transcribed as written)
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town:  Softshell              Residence on a Farm?: Yes
Street Address: Rural    Residence inside City Limits?:   No
Full Name:  Mrs. Emeline SMITH
Date of Death:  24 April 1956
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth:  25 March 1881
Age: 75 years
Usual Occupation:  Housewife
Kind of Industry or business: Own Home
Birthplace:  Knott County, Ky.
Father's Name:  William CASEBOLT
Mother's Maiden Name:  Polly MAGGARD
Was deceased ever in armed forces:  No
Social Security No.: (blank)
Informant:  Mrs. Lewis GAYHEART
Disease or condition directly leading to death: Cardio Vascular
Interval between onset and death:  02 years
Due to: (blank)
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 April 1955 to 24 April 1956, that I last saw the deceased alive on 24 April 1956, and that death occurred at 12 noon, from the causes and on the date stated above.
Date signed:   08 May 1956
Address:  Wayland, Ky.
Signature:  M. V. Wicker, M.D.
Burial, Cremation or Removal: Burial
Date:  27 April 1956
Name of Cemetery or Crematory:  Family
Location:  Knott County, Ky.
Date received by local registrar:  14 May 1956
Registrar's Signature: Myrtle Slone
Funeral director & address:  Eastin - Richey, Mt. Sterling, Ky.
Transcribed by Debbie Tamborski, 26 March 2012