Date:  02 May 1949
Cert:  12354 
Place of Death: County: Knott      City or Town: Emmalena, Ky.
Length of stay (in this place): 18 months
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Kentucky   County: Knott
City or Town: Emmalena    Street Address: Montgomery Creek
Full Name:  Mrs. Nancy Ann SMITH
Date of Death:  02 May 1949
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth:  27 December 1866
Age:  82 years
Usual Occupation:  Housewife
Kind of Industry or business: Domestic
Birthplace:  Cordia (Perry Co.), Ky.
Father's Name:  John GRIGSBY
Mother's Maiden Name:  Lucy ENGLE
Was deceased ever in armed forces: No
Social Security No.:  None
Informant:  Grandson - D. L. COMBS
Disease or condition directly leading to death:  Arteriosclerotic Heart Disease Decompensated
Interval between onset and death: 03 months
Due to (b):  Arteriosclerosis
Interval between onset and death: unknown
Due to: Senility
Interval between onset and death: 10 years
Other significant conditions: Scoliosis
Interval between onset and death: all life
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 10 March 1949 to 22 March 1949, that I last saw the deceased alive on 10 March 1949, and that death occurred at 3:00 a.m., from the causes and on the date stated above.
Date signed:  04 May 1949
Address:  Hindman, Ky.
Signature:  D. G. Barker, M.D.
Burial, Cremation or Removal:  Burial
Date:  Smith Cemetery
Name of Cemetery or Crematory:  Ritchie, Ky.
Location:  14 June 1949
Date received by local registrar: Rose B. Craft
Registrar's Signature:  (Family)
Funeral director & address:
Transcribed by Debbie Tamborski, 08 January 2011