DEATH CERTIFICATE
(stillbirth) CAMPBELL

Date    14 December 1911
Deathvol Vol:   1911
Cert: #  32421
Name:  (stillbirth) CAMPBELL
Male, White, Single
Age:  00 years, 00 month, 00 days
Place of Death: Voting Pct. Lost Creek, Perry Co., KY
Birth Date:  14 December 1911
Place of Birth:  Kentucky
Father:  Green CAMPBELL                                                 Birthplace Father: Kentucky
Mother:  Corsia HAYS                                                Birthplace Mother:  Kentucky
Informant:  Rebecca MCLEMORE, Midwife
Death Date:  14 December 1911
Cause of Death:  Stillbirth, falling ?___? of mother
Signed:  Rebecca Mclemore, Midwife
Burial Place:  Mouth of Tom's Branch
Undertaker:  Rebecca Mclemore
File Date: 01 January 1912
Transcribed by Debbie Tamborski, 19 June 2008