DEATH CERTIFICATE
(stillbirth) BOLEN

Date    15 December 1914
Deathvol Vol:   1914
Cert: #  32203
Name:  (stillbirth) BOLEN
Male, White
Age:  (Blank)
Place of Death: Voting Pct. No. 9, Knott Co., KY
Birth Date:  15 December 1914
Place of Birth:  Knott Co.
Father:  Green BOLEN                                                 Birthplace Father:  Knott Co.
Mother:  Alefare GAYHART                                                    Birthplace Mother:  Knott Co.
Informant:  Green BOLEN, Yal Mt., Ky.
Death Date:  15 December 1914
Cause of Death:  Stillbirth
Signed:  Jane Hicks, M.D.
Burial Place:  Bolen
Undertaker:  (Blank)
File Date: 16 January 1915
Transcribed by Debbie Tamborski, 24 July 2008