DEATH CERTIFICATE

DELILIEFAIR ADAMS

 

Date    16 April 1914
Deathvol Vol:   1914
Cert: #  10813
Name:  Deliliefair ADAMS
Female, Black, Single
Age:  1 years, 8 months, 12 days
Place of Death: Voting Pct. No. 6, Knott Co., KY
Birth Date:  04 August 1912
Place of Birth:  Knott Co., Ky.
Father:  Dan ADAMS                                                   Birthplace Father:  Knott Co., Ky.
Mother:  Phoebe WILLIAMS                                       Birthplace Mother:  Knott Co., Ky.
Informant:  Dan ADAMS, Smithsboro, Ky.
Death Date:  16 April 1914
Cause of Death:  Pneumonia Fever  Contributory: Whooping Cough
Signed:  Polly An Roark, M.D.
Burial Place:  Smith Grave
Undertaker:  Dan Adams, Smithsboro, Ky.
File Date: 16 April 1914
Transcribed by Debbie Tamborski, 24 July 2008