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DEATH
CERTIFICATE
(Not named) SMITH
Date 18 December 1936
Cert: 33612
Name: (Not named) SMITH
Place of Death: Voting Pct. , Knott Co., KY
Residence: (blank)
Length of residence: (blank)
Male, White, Single
Husband or Wife of: (blank)
Birth Date: 18 December 1936
Age: (blank)
Occupation: (blank)
Place of Birth: Knott Co., Ky.
Name of Father: Kermit SMITH
Birthplace Father: Knott Co., Ky.
Maiden Name of Mother: Oaklie WALLEN
Birthplace Mother: Knott Co., Ky.
Informant: Kermit SMITH, Hindman, Ky.
Death Date: 18 December 1936
Cause of Death: Lobar pneumonia
Signed: M. F. Kelley, M.D., Hindman, Ky.
Burial Place: Knott Co.
Date of Burial: 19 December 1936
Undertaker: Kermit Smith, Hindman, Ky.
File Date: 15 January 1937
Registrar: Rhoda C. Kelley
Transcribed by Debbie Tamborski, 19 September 2009 |
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