Date:    07 February 1948
Cert:    03517 
Place of Death: County: Knott   City or Town:  Hindman, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Hindman, Ky. 
Full Name:  Sam SMITH 
If Veteran Name War: War II
Social Security No.:  (blank)
Sex, Color or Race, Marital Status:  Male, White, Married
Husband or Wife of:  Sarah HAYNE SMITH
Age of husband or wife if alive: 60 years
Birth date of deceased:  (blank) 
Age:  36 years
Birthplace:  Knott Co., Ky. 
Occupation:  Farmer 
Industry or business:  (blank)
Father Name:  John SMITH 
Father Birthplace:  Knott Co., Ky. 
Mother Maiden Name:  Martha HONEYCUT 
Mother Birthplace:   Knott Co., Ky. 
Informant:  Shelley SMITH, Hindman, Ky.
Burial Place:  Family Cemetery, Hindman 
Date:  09 February 1948 
Signature of funeral director:  Joe Greer, Hazard, Ky.
Date received by local registrar:  17 February 1948 
Registrar's Signature:  Rose B. Craft
Date of Death:  07 February 1948 
I hereby certify that I attended deceased from 07 February 1948 to 07 February 1948, that I last saw him alive on (blank), and that death occurred on the date stated above at 11 a.m.
Immediate cause of death:  Gunshot wound in the head.  Died instantly. 
Duration: (blank)
Due to:  (blank)
Major findings of operations: (blank)
Accident, suicide, or homicide: Suicide
Date of occurrence: 07 February 1948
Where did injury occur: Home
While at work:  (blank)
Means of injury:  Gunshot
Signature & Address:  M. F. Kelley, M.D., Hindman, Ky.
Date signed:  11 February 1948 
Transcribed by Debbie Tamborski, 29 December 2010