DEATH CERTIFICATE

IRA ADKINS

 

Date 18 January 1917
Cert:  00916
Place of Death: Voting Precinct:  Painter Harve, Weeksbury, Floyd Co., KY
Full Name:  Ira ADKINS
Sex, Color or Race, Marital Status:  Male, White (blank)
Date of Birth:  19 September 1915
Age: 01 years, 05 months
Occupation:  (blank)
Birthplace:  Beaver, Ky.
Name of Father:  Andy ADKINS
Birthplace Father:  Floyd Co., Ky.
Maiden name of Mother:  Willia Anna GAYHEART
Birthplace Mother:  Beaver, Ky.
Informant/Address:  (blank)
Filed:  01 February 1917
Registrar:  E. Hiram Hall
Death Date:  18 January 1917
I hereby certify that I attended deceased from 12 January 1917, to 18 January 1917, that I last saw him alive on 18 January 1917, and that death occurred, on the date stated above, at 12 p.m.
Cause of Death:  Measles
Duration:  (blank)
Contributory:  (blank)
Signed/Address:  Dr. W. L. Stumbo, M.D., Weeksbury, Ky.
Length of residence where disease contracted:  (blank)
Former or usual residence:  (blank)
Place of Burial or Removal:  Beaver, Ky.
Date of Burial:  20 January 1917
Undertaker/Address:  Edward Gayheart, Weeksbury, Ky.
Transcribed by Debbie Tamborski, 28 February 2010