Date: 11 January 1954
Cert: #16294
Place of Death: County: Knott
City or Town: Softshell, Ky. Rural
Length of stay (in this place): Life
Street address or location: Pt. died at home on
Softshell
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Softshell Rural
If rural give location: On Head of Ball's Fork
Full Name: Phena SMITH
Date of Death: 11 January 1954
Sex, Color or Race, Marital Status: Female, White, Married
Date of Birth: 17 September 1888
Age: 65 years
Usual Occupation: Housewife
Kind of Industry or business: Home
Birthplace: Ky.
Father's Name: W. B. PRATT
Mother's Maiden Name: Lucy MAGGARD
Was deceased ever in armed forces: No
Social Security No.: (blank)
Informant: Chester SMITH
Disease or condition directly leading to death: Disease of
heart
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 10 January 1954 to
10 January 1954, that I last saw the deceased alive on 10
January 1954, and
that death occurred at 11 p.m., from the causes and on the
date stated above.
Date signed: 27 January 1954
Address: Hindman, Ky.
Signature: M. F. Kelly, M.D.
Burial, Cremation or Removal: Burial
Date: 13 January 1954
Name of Cemetery or Crematory: Family Cemetery
Location: Leburn, Ky.
Date received by local registrar: 03 February 1954
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: John Taul, Hindman, Ky.
Transcribed by Debbie Tamborski, 12 March 2011 |