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DEATH
CERTIFICATE
GEO. W. SMITH
Date 12 December 1918
Cert: 13014
Place of Death: Voting Precinct: No. 1 Garrard, Clay Co., Ky.
Full Name: Geo. W. SMITH
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 26 March 1888
Age: 30 years, 08 months, 16 days
Occupation: Farmer
Birthplace: Knott Co., Ky.
Name of Father: Jeremiah SMITH
Birthplace Father: Letcher Co., Ky.
Maiden name of Mother: Lucinda KELLEY
Birthplace Mother: Letcher Co., Ky.
Informant/Address: Jeremiah SMITH, Garrard, Ky.
Filed: (blank)
Registrar: (blank)
Death Date: 12 December 1918
I hereby certify that I attended deceased from 10 December
1918, to
12 December 1918, that I last saw him alive on 11 December
1918, and that death occurred, on the date stated above, at 4
a.m.
Cause of Death: Pneumonia complicating influenza
Duration: 08 days
Contributory: (blank)
Signed/Address: J. L. Anderson, M.D., 12 December 1918,
Manchester, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Clay Co., Ky.
Date of Burial: 13 December 1918
Undertaker/Address: Jeremiah Smith, Garrard, Ky.
Transcribed by Debbie Tamborski, 05 March 2010 |
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