Date:  29 April 1940
Cert:  12867
Place of Death: County: Knott     City or Town: Pippapass
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Ky.      County: Knott
City or Town:  Pippapass
Full Name:  Warsh B. SMITH
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Male, White, Married
Husband or Wife of:  Martha Bell SHORT
Age of husband or wife if alive:  49 years
Birth date of deceased:  18 June 1881
Age: 59 years
Birthplace:  Knott Co.
Occupation:  Farmer
Industry or business: (blank)
Father Name:  Bill SMITH
Father Birthplace:  Knott 
Mother Maiden Name:  Nancy THACKER
Mother Birthplace:  Knott
Informant:  Pearl SHORT
Burial Place:  Steer Fork
Date:  30 April 1940
Signature of funeral director: (blank)
Date received by local registrar:  28 May 1940
Registrar's Signature:  Macie Miller
Date of Death:  29 April 1940
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: Fell dead
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. W. Duke, M.D., Hindman, Ky.
Date signed:  (blank)
Transcribed by Debbie Tamborski, 06 October 2010