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DEATH
CERTIFICATE
JOHN BRYAN SMITH
Date 28 March 1934
Cert: 06739
Place of Death: Voting Pct.: Louisville, Jefferson Co.,
Ky.
Full Name: John Bryan SMITH
Residence: Watterson Hotel
Length of Residence: (blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: (blank)
Age: 37 years
Occupation: (blank)
Birthplace: Hindman, Ky.
Father Name: G. C. SMITH
Birthplace Father: Breathitt Co., Ky.
Mother Maiden Name: Mary B. BAKER
Birthplace Mother: Kentucky
Informant/Address: W. R. SMITH, Hindman, Ky.
Burial Cremation Removal Place: Hindman, Ky.
Date: 30 March 1934
Undertaker/Address: (illegible) W. Smith & Son, 1029 S. 6th
St.
Filed: 30 March 1934
Registrar: A. E. Warfield, Deputy
Death of Date: 28 March 1934
I hereby certify, That I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), death is said
to have occurred on the date stated above, at 11:30
Cause of Death: 1, 2 & 3 Degree Burns
Date of onset: (blank)
Contributory causes: Suffocation
Name of operation: (blank)
Accident, suicide, homicide: Accident
Date of Injury: (blank)
Where did injury occur: Louisville, Ky.
Specify whether injury occurred industry, home, public place:
Watterson Hotel
Manner of injury: Smoking in bed
Nature of injury: 1, 2 & 3 Degree Burns
Related to occupation: (blank)
Signed/Address: Dr. John M. McKeaney, Coroner by M.
Rodger Dougherty, Deputy
Transcribed by Debbie Tamborski, 16 April 2010
*Transcribers note: Buried Granby Carew Smith Cemetery
Located at Frogtown, Hindman, Ky as Jennings Bryan Smith |
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