|
DEATH
CERTIFICATE
MELDA SMITH
Date: 15 March 1953
Cert: 08498
Place of Death: County: Letcher City or Town:
Isom
Length of stay (in this place): (blank)
Street address or location: Home
Usual Residence of Deceased: State: Ky. County:
Letcher
City or Town: Isom, Ky. Street Address: (blank)
Full Name: Melda SMITH
Date of Death: 15 March 1953
Sex, Color or Race, Marital Status: Female, White, Widow
Date of Birth: 28 August 1862
Age: 90 years
Usual Occupation: none
Kind of Industry or business: (blank)
Birthplace: Knott Co., Ky.
Father's Name: Jack COMBS
Mother's Maiden Name: Mary Ann YOUNG
Was deceased ever in armed forces: no
Social Security No.: none
Informant: Martha AMBURGEY
Disease or condition directly leading to death:
Pneumonia
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 13 January 1953 to
14 March 1953, that I last saw the deceased alive on 14 March
1953, and
that death occurred at 15 March 1953, from the causes and on the
date stated above.
Date signed: 20 April 1953
Address: Hindman, Ky.
Signature: J. W. Duke, M.D.
Burial, Cremation or Removal: Burial
Date: 12 March 1953
Name of Cemetery or Crematory: Spencer Combs Cemetery
Location: Smithsboro, Ky.
Date received by local registrar: 22 April 1953
Registrar's Signature: G. W. Collins
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 13 August 2010 |
|