DEATH CERTIFICATE

MYRTLE ORA AMBURGY

Date  16 November 1911
Deathvol 
Vol:   1911
Cert: # 17-29021
Name: Myrtle Ora AMBURGY
Female, White, Single
Age: 1 year, 2 months, 8 days
Place of Death: Voting Pct No. 2, Knott Co., KY
Birth Date:  16 November 1911
Place of Birth:  Kentucky
Father:  Robert BATES
Mother:  Diannah AMBURGY 
Informant:  Not Listed
Death Date:  16 November 1911
Cause of Death:  Pulmonary Phthisis
Signed:   Owen Pigman, M.D.
Burial Place:  Wm. Amburgey
Undertaker:  John S. Amburgey
File Date:  18 November 1911