Date:  19 February 1953
Cert:  06055 
Place of Death: County: Knott      City or Town:  Carrie
Length of stay (in this place): (blank)
Name of Hospital or Institution:  (blank)
Usual Residence of Deceased: State: Ky.     County: Knott
City or Town:  Carrie     If rural give location: (blank)
Full Name:  Mae SMITH 
Date of Death:  19 February 1953 
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth:  01 September 1915 
Age:  37 years
Usual Occupation:  (blank)
Kind of Industry or business: housewife
Birthplace:  Knott Co., Ky. 
Father's Name:  Ralph JACOBS 
Mother's Maiden Name:  Lizebeth GRUBBS 
Was deceased ever in armed forces: (blank)
Social Security No.:  (blank)
Informant:  Dan SMITH 
Disease or condition directly leading to death: Pulmonary T. B.
Interval between onset and death:  (blank)
Due to:  (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from (blank) to 19 February 1953, that I last saw the deceased alive on (blank), and that death occurred at (blank), from the causes and on the date stated above.
Date signed:  05 March 1953
Address:  Hindman, Ky.
Signature:  J. W. Duke, M.D.
Burial, Cremation or Removal: Burial
Date:  21 February 1953
Name of Cemetery or Crematory: Smith Cemetery
Location:  Carrie, Ky.
Date received by local registrar: 06 March 1953
Registrar's Signature: Rose B. Craft
Funeral director & address:  John Everage, Hindman, Ky.
Transcribed by Debbie Tamborski, 11 February 2011