Date: 18 July 1945
Cert: 15252
Place of Death: County: Knott City or
Town: Rural - Smithsboro, Ky.
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: Flax Patch 09 months
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Rural If rural
give precinct: Smithsboro
Full Name: Sidney Barnes SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Widowed
Husband or Wife of: Alice SMITH
Age of husband or wife if alive: (blank)
Birth date of deceased: 14 October 1869
Age: 75 years, 09 months, 04 days
Birthplace: Smithboro, Ky.
Occupation: Farming
Industry or business: (blank)
Father Name: Jerry SMITH
Father Birthplace: Smithboro, Ky.
Mother Maiden Name: Betty STACY
Mother Birthplace: Sassafras, Ky.
Informant: Nord MOORE, Amburgey, Ky.
Burial Place: Smithsboro, Ky.
Date: 18 July 1945
Signature of funeral director: None - Friends, Smithsboro,
Ky.
Date received by local registrar: 24 July 1945
Registrar's Signature: Rose B. Craft
Date of Death: 18 July 1945
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw him alive on (blank), and that death
occurred on the date stated above at (blank)
Immediate cause of death: Cancer of Stomach
Duration: (blank)
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 & Address: J. R. Aker, M.D., Anco, Ky.
Date signed: 20 July 1945
Transcribed by Debbie Tamborski, 30 November 2010 |