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DEATH
CERTIFICATE
OLLIE SMITH
Date 14 May 1949
Cert: 19477
Place of Death: County: Perry City or Town:
Hazard
Length of stay in hospital or community:
Name of Hospital or Institution: Hurst - Snyder
Usual Residence of Deceased: State: Ky. County: Knott
City or Town: Cordia
Full Name: Ollie SMITH
Date of Death: 14 May 1949
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 1921
Age: 28 years
Usual Occupation: Housewife
Kind of Industry or business: (blank)
Birthplace: Knott
Father's Name: Bill DOBSON
Mother's Maiden Name: Lucinda SMITH
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Alford SMITH
Disease or condition directly leading to death: Acute
decompensation and dilation of rt. heart
Interval between onset and death: (blank)
Due to: Chronic Rheumatic Heart Disease
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (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 10 May 1949 to
14 May 1949, that I
last saw the deceased alive on 14 May 1949, and that death occurred on
the date stated above at 2 a.m., from the causes and on the date
stated above.
Date signed: (blank)
Address: (blank)
Signature: Paul W. Gutsche, M.D.
Burial, Cremation or Removal: Burial
Date: 15 May 1949
Name of Cemetery or Creamatory: Smith
Location: Knott, Ky.
Date received by local registrar: 03 October 1949
Registrar's Signature: Georgia Pendleton
Funeral director and address: Engle's, Hazard, Ky.
Transcribed by Debbie Tamborski, 16 February 2010 |
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