Date 05 June 1954
Cert:  # 16299
Place of Death: County:  Knott
City or Town: Lackey
Length of stay in hospital or community: 1 Hour
Name of Hospital or Institution:  Stumbo Memorial Hosp.
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Jones Fork
Full Name: Sherill Smith
Date of Death:  05 June 1954
Sex, Color or Race, Marital Status: male, white, single
Date of Birth:  29 June 1935
Age: 18
Usual Occupation: Carpenter
Kind of Industry or business: Building
Birthplace:  Kentucky USA
Father's Name:  Estill Smith
Mother's Maiden Name: Edna Slone
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Edna Slone Smith ~ Mother
Disease or condition directly leading to death: Internal Hemorrhage
Interval between onset and death: 
Due to:  Auto Accident
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for operation: (blank)
Accident, suicide, or homicide: Accident
Place of injury: Highway
City or Town, County, State: Hindman, Knott, KY
Time of Injury: 05 Jun 1954 11 am
Injury occurred at work: At Work
How did injury occur:  Auto Accident ~ Ran off Highway
I hereby certify that I attended deceased from 05 Jun 1954 to 05 Jun 1954, that I last saw the deceased alive on 11:50 am, and that death occurred on the date stated above at  from the causes and on the date stated above.
Date signed: 18 June 1954
Address: Lackey, Kentucky
Signature:  Charles L. Roach, MD
Burial, Cremation or Removal: Burial
Date:  07 June 1954
Name of Cemetery or Crematory: Smith Cemetery
Location: Softshell KY
Date received by local registrar: 18 June 1954
Registrar's Signature: Rose B. Craft
Funeral director and address: John N. Taul ~ Hindman, KY
Transcribed by Gloria Marcum ~ 23 February 2010