|
DEATH
CERTIFICATE
LUCINDA SMITH
Date: 19 October 1943
Cert: 21668
Place of Death: County: Clay City or Town:
Rural
Street No. or Location: Garrard, Ky.
Length of stay in hospital or community: 24 years
Usual Residence of Deceased: State: Ky. County:
Clay
City or Town: Rural
Full Name: Lucinda SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Widowed
Husband or Wife of: Jeremiah SMITH
Age of husband or wife if alive: (blank)
Birth date of deceased: 28 February 1869
Age: 74 years, 07 months, 19 days
Birthplace: Knott Co., Ky.
Occupation: Housework
Industry or business: Home
Father Name: Thomas KELLEY
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Minerva YOUNG
Mother Birthplace: Knott Co., Ky.
Informant: W. M. MAGGARD, (?Booneville? illegible), Ky.
Burial Place: Garrard, Ky.
Date: 20 October 1943
Signature funeral director: C. Fred Rominger, Manchester, Ky.
Date received by local registrar: 20 October 1943
Registrar's Signature: Lillian Wagers
Date of Death: 19 October 1943
I hereby certify that I attended deceased from 10 October 1943 to
19 October 1943, that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Hypertensive Heart Disease
Duration: (blank)
Due to: (blank)
Other Conditions: Senility
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: D. D. Turner, M.D., Manchester,
Ky.
Date signed: 21 October 1943
Transcribed by Debbie Tamborski, 02 June 2010 |
|