Date:  11 June 1949
Cert:  16792 
Place of Death: County: Knott    City or Town: Smithsboro, Ky.  Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution:  None
Usual Residence of Deceased: State: Kentucky    County: Knott
City or Town:  Smithsboro   Rural    If rural give precinct:  On Carr Creek
Full Name:   Matilda AMBURGEY SMITH
Date of Death:  11 June 1949
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth:  1868
Age:  81 years
Usual Occupation: Housewife
Kind of Industry or business: Housekeeping
Birthplace:  Litt Carr, Knott Co., Ky.
Father's Name:  William AMBURGEY
Mother's Maiden Name:  Elizabeth STAMPER
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: (blank)
Disease or condition directly leading to death:  Bad heart
Interval between onset and death:  (blank)
Due to:  Complications that go with old age
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (blank)
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 (blank), 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:  31 August 1949
Address:  Hindman, Ky.
Signature:  J. W. Duke, M.D.
Burial, Cremation or Removal:  Burial
Date:  13 June 1949
Name of Cemetery or Crematory:  Combs Cemetery
Location:  Smithsboro, Knott, Ky.
Date received by local registrar: 31 August 1949
Registrar's Signature:  Rose B. Craft
Funeral director & address:  Maggard & Garrett, Hazard, Ky.
Transcribed by Debbie Tamborski, 08 January 2011