Date: 03 March 1954
Cert: 26618
Place of Death: County: Knott
City or Town: Vest - Rural
Length of stay (in this place): (blank)
Name of Hospital or Institution: (blank)
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Vest - Rural If rural give
location:
(blank)
Full Name: Sarah SMITH
Date of Death: 03 March 1954
Sex, Color or Race, Marital Status: Female, White, Widow
Date of Birth: 04 May 1888
Age: 66 years
Usual Occupation: Housewife
Kind of Industry or business: Housewife
Birthplace: Knott Co., Ky.
Father's Name: David STURGILL
Mother's Maiden Name: Raney BRADLEY
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Ernest SMITH
Disease or condition directly leading to death: High blood
pressure and Disease of the heart
Interval between onset and death: (blank)
Due to: (blank)
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: (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 04 January 1954 to
03 March 1954, that I last saw the deceased alive on 24
February 1954, and
that death occurred at 8 p.m., from the causes and on the
date stated above.
Date signed: 05 March 1954
Address: Hindman, Ky.
Signature: M. F. Kelley, M.D.
Burial, Cremation or Removal: Burial
Date: 05 March 1954
Name of Cemetery or Crematory: Smith Cemetery
Location: Soft Shell, Ky.
Date received by local registrar: 05 May 1954
Registrar's Signature: Mrs. Rose B. Craft
Funeral director & address: John Everage, Hindman,
Ky.
Transcribed by Debbie Tamborski, 24 February 2011 |