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DEATH
CERTIFICATE
ROSEANNA CAUDILLE
Date 11 October 1912
Cert: 24656
Place of Death: Voting Precinct: #5816, Fed, Floyd Co.,
KY
Full Name: Roseanna CAUDILL
Sex, Color or Race, Marital Status: Female, White,
Infant
Date of Birth: 12 May 1912
Age: 04 months, 29 days
Occupation: Infant
Birthplace: Knott Co., Ky.
Name of Father: Harilee MULINS
Birthplace Father: Floyd Co., Ky.
Maiden name of Mother: Evaline CAUDILLE
Birthplace Mother: Floyd Co., Ky.
Informant/Address: Evaline CAUDILLE, Fed, Ky.
Filed: 11 November 1912
Registrar: Hiram Hall
Death Date: 11 October 1912
I hereby certify that I attended deceased from 01 October 1912, to
11 October 1912, that I last saw her alive on 11 October 1912, and that death
occurred, on the date stated above, at 9 p.m.
Cause of Death: Spinal disease of the spine
Duration: 11 days
Contributory: (blank)
Signed/Address: Emit King, M.D., 11
November 1912, Melvin, Ky.
Place of Burial or Removal: W. R. Hall, G. Yard
Date of Burial: 12 October 1912
Undertaker/Address: Ben Caudille, Melvin, Ky.
Transcribed by Debbie Tamborski, 24 February 2010 |
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