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DEATH
CERTIFICATE
VIRGIL SMITH
Date 06 November 1953
Cert: 22243
Place of Death: County: Fayette City or Town: Lexington
Length of stay in hospital or community: 03 days
Name of Hospital or Institution: Good Samaritan Hospt.
Usual Residence of Deceased: State: Kentucky County: Knott
City or Town: Fisty
Full Name: Virgil SMITH
Date of Death: 06 November 1953
Sex, Color or Race, Marital Status: Male, White, Single
Date of Birth: 02 June 1923
Age: 30 years
Usual Occupation: not known
Kind of Industry or business: (blank)
Birthplace: Perry County, Ky.
Father's Name: James Edward SMITH
Mother's Maiden Name: Polly FUGATE
Was deceased ever in armed forces: Yes
Social Security No.: (blank)
Informant: Hospital Records
Disease or condition directly leading to death: Uremia,
acidosis and anemia
Interval between onset and death: several weeks
Due to (b): marked renal insufficiency
Interval between onset and death: since 1951
Due to (c): Surgical absence of rt. kidney and
(illegible) nephritis, severe, (illegible), left
Interval between onset and death: 1948
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (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 03 November
1953 to 06 November 1953, that I last saw the deceased alive
on 06 November 1953, and that death occurred on the date
stated above at 8:15 p.m., from the causes and on the date
stated above.
Date signed: 12 November 1953
Address: 203 W. 2nd St.
Signature: M. Randolph Gilliam, M.D.
Burial, Cremation or Removal: Burial
Date: 09 November 1953
Name of Cemetery or Crematory: Fisty Cemetery
Location: Fisty, Ky.
Date received by local registrar: 11 November 1953
Registrar's Signature: D. A. Furlong
Funeral director and address: Maggard and Garrett, Hazard, Ky.
Transcribed by Debbie Tamborski, 21 February 2010 |
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