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DEATH
CERTIFICATE
VINA BELL SMITH
Date: 19 July 1946
Cert: 16331
Place of Death: County: Perry City or Town:
Vicco, Ky.
Street No. or Location: Home, Vicco, Ky.
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky. County:
Perry
City or Town: Vicco, Ky.
Full Name: Vina Bell SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of: Thomas SMITH
Age of husband or wife if alive: 64 years
Birth date of deceased: 21 March 1886
Age: 60 years, 03 months, 28 days
Birthplace: Knott Co., Ky.
Occupation: House wife
Industry or business: (blank)
Father Name: Hillard SMITH
Father Birthplace: Knott Co., Ky.
Mother Maiden Name: Armilda COMBS
Mother Birthplace: Knott Co., Ky.
Informant: Thomas SMITH, Vicco, Ky.
Burial Place: Irshman
Date: 21 July 1946
Signature of funeral director: Jimmie Blair, Hazard, Ky.
Date received by local registrar: 22 July 1946
Registrar's Signature: Opsie J. Deaton
Date of Death: 19 July 1946
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 4 p.m.
Immediate cause of death: Heart Failure
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: Earl Maggard, Coroner, Hazard,
Ky.
Date signed: 22 July
Transcribed by Debbie Tamborski, 11 June 2010 |
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