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DEATH
CERTIFICATE
WENDELL P. SMITH
Date 31 October 1930
Cert: 24405
Place of Death: Vot. Pct: 8 mi. Winchester Rd., Fayette Co.,
Ky.
Full Name: Wendell P. SMITH
Residence: Hindman, Ky.
Length of Residence in city where death occurred:
(blank)
Sex, Color or Race, Marital Status: Male, White, Single
Husband or Wife of: (blank)
Date of Birth: about 1904
Age: 26 years
Occupation: Merchant
Birthplace: Knott Co., Ky.
Father Name: G. C. SMITH
Birthplace Father: Knott Co., Ky.
Mother Maiden Name: Alice B. SMITH
Birthplace Mother: Knott Co., Ky.
Informant/Address: H. H. SMITH, Hindman, Ky.
Filed: 04 November 1930
Registrar: D. A. Furlong
Death of Date: 31 October 1930
I hereby certify that I attended deceased from (blank) to
(blank), that I last saw h-- alive on (blank), and that death
occurred on the date stated above at about 5 p.m.
Cause of Death: Fractured skull & concussion of Brain
and internal injuries sustained in auto accident
Duration: (blank)
Contributory: Auto Accident 8 mi.
Winchester road (Fayette Co.)
Duration: (blank)
Where was disease contracted if not at place of death?:
(blank)
Did an operation precede death: (blank) Date: (blank)
Was there an autopsy: (blank)
What test confirmed diagnosis: (blank)
Signed/Address: J. H. Kerr, Coroner, 03
November 1930, Lexington, Ky.
Place of Burial or Removal: Hindman, Ky.
Date of Burial: 02 November 1930
Undertaker/Address: Kerr Bros., Lex., Ky.
Transcribed by Debbie Tamborski, 29 March 2010 |
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