Date:    23 November 1947
Cert:    24766 
Place of Death: County: Knott   City or Town: Fisty, Ky.  Rural
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:  Fisty     Rural 
Full Name:  Jasper SMITH 
If Veteran Name War: (blank)
Social Security No.:  (blank)
Sex, Color or Race, Marital Status:  Male, White, Married
Husband or Wife of:  Tilda SMITH
Age of husband or wife if alive: 54 years
Birth date of deceased:  May 1882 
Age: 65 years, 06 months
Birthplace:  Knott 
Occupation:  Farmer 
Industry or business:  (blank)
Father Name:  Sam SMITH 
Father Birthplace:  Knott 
Mother Maiden Name:   Diana SMITH 
Mother Birthplace:   Knott 
Informant:  James SMITH, Bulan, Ky. 
Burial Place:   Knott 
Date:  25 November 1947 
Signature of funeral director:  Engle's, Hazard, Ky.
Date received by local registrar:  29 November 1947 
Registrar's Signature:  Rose B. Craft
Date of Death:  23 November 1947 
I hereby certify that I attended deceased from 23 November 1947 to 23 November 1947, that I last saw him alive on 23 November 1947, and that death occurred on the date stated above at 8 p.m.
Immediate cause of death:  Pulmonary T. B.
Duration: 03 years
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. C. Coldiron, M.D., Hazard, Ky.
Date signed:  28 November 1947 
Transcribed by Debbie Tamborski, 20 December 2010