DEATH CERTIFICATE

DIXIE BOLEN

Date 20 September 1912
Deathvol
Vol:   1913
Cert: # 5898
Name: Dixie BOLEN
Male, White, Single
Age: Not Listed
Place of Death: Voting Pct Boleyn, Jones Fork, Knott Co., KY
Birth Date: Not Listed
Place of Birth: Boleyn, Knott Co., KY
Father: Wheatley BOLEN, Jr.                                         Birthplace Father: Lackey, Knott Co., KY
Mother: Francis HIX                                                   Birthplace Mother: Knott Co., KY
Informant: S.B. Bolen
Death Date: 20 September 1912
Cause of Death: Tonsillitis     Contributory: Pneumonia
Signed:   MV. Wicker, M.D.
Burial Place: Boleyn Cemetery
Undertaker: J.M. Boleyn
File Date: 10 April 1913
Transcribed by Debbie Tamborski, 13 June 2008