Date  24 August 1954
Cert:  # 48291
Place of Death: County:     Knott
City or Town: Lackey
Length of stay in hospital or community:
Name of Hospital or Institution:   Stumbo Memorial
Usual Residence of Deceased: State: Kentucky
County: Knott
City or Town: Betty
Full Name: Blaine Thacker
Date of Death: 
Sex, Color or Race, Marital Status:
Date of Birth:  01 June 1903
Age: 51
Usual Occupation: Miner
Kind of Industry or business: Coal
Birthplace:  Knott Co.
Father's Name:  Robert Thacker
Mother's Maiden Name: Sabra Smith
Was deceased in ever in armed forces: (blank)
Social Security No.: (blank)
Informant: Mrs. Blaine Thacker
Disease or condition directly leading to death:  Acute Pancreatitis
Interval between onset and death: 
Due to: 
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings for 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 21 September 1954 to 23 September 1954, that I last saw the deceased alive on , 24 September 1954 and that death occurred 12:24 AM on the date stated above at  from the causes and on the date stated above.
Date signed: 
Address: Lackey, KY
Signature:  Charles L. Roach, MD
Burial, Cremation or Removal:  Burial
Date:  25 September 1954
Name of Cemetery or Crematory: Conley Cemetery
Location:  Betty, KY
Date received by local registrar: 04 Dec 1954
Registrar's Signature: Myrtle Slone
Funeral director and address: John Everage ~ Hindman, KY
Transcribed by Gloria Marcum ~ 15 March 2010