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DEATH
CERTIFICATE
RUTH SMITH
Date 31 August 1945
Cert: 19988
Place of Death: County: Perry City or
Town: Hazard
Name of Hospital or Institution: Hazard Hosp. Co.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott Co.
City or Town: Rural Street No.:
Sasfrass
Full Name: Ruth SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Single
Husband or Wife of: (blank)
Age of husband or wife if alive: (blank)
Birth date of deceased: 01 April 1945
Age: 04 months, 29 days
Birthplace: Perry Co.
Occupation: (blank)
Industry or business: (blank)
Father Name: Sam SMITH
Father Birthplace: Owsley Co., Ky.
Mother Maiden Name: Mary BREWER
Mother Birthplace: Corbin, Ky.
Informant: (blank), Sasfrass
Burial Place: Sasfrass
Date: (blank)
Signature of funeral director: Greer & Towsend, Hazard, Ky.
Date received by local registrar: 05 October 1945
Registrar's Signature: O. J. Deaton
Date of Death: 31 August 1945
I hereby certify that I attended deceased from 28 August 1945 to
31 August 1945, that I
last saw him alive on 31 August 1945, and that death occurred on the date
stated above at 7:30 a.m.
Immediate cause of death: acute dysentery
Due to: (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature: Chris S. Jackson, M.D., Hazard, Ky.
Date signed: 07 September 1945
Transcribed by Debbie Tamborski, 09 February 2010 |
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