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DEATH
CERTIFICATE
LOUIZA CHRISTAIN
Date 11 June 1920
Cert: Duplicate # 08474 Original
#08475
Place of Death: Voting Precinct: Letcher Co., Ky.
Full Name: Louiza CHRISTAIN
Sex, Color or Race, Marital Status: Female, Black,
Single
Date of Birth: 1905
Age: 15 years
Occupation: (blank)
Birthplace: Knott Co., Ky.
Name of Father: Wm. CHRISTAIN
Birthplace Father: Knott Co., Ky.
Maiden name of Mother: Polly WILLIAMS
Birthplace Mother: Knott Co., Ky.
Informant/Address: Wm. CHRISTAIN, Redfox, Ky.
Filed: 12 June 1920
Registrar: (illegible) Cornett
Death Date: 11 June 1920
I hereby certify that I attended deceased from (blank), to
(blank), that I last saw h-- alive on (blank), and that death
occurred, on the date stated above, at (blank)
Cause of Death: Typhoid Fever
Duration: (blank)
Contributory: (blank)
Signed/Address: G. D. Ison, M.D., 11 June 1920, Indian Bottom
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Shade Smiths
Date of Burial: 12 June 1920
Undertaker/Address: Wm, Christain, Redfox, Ky.
Transcribed by Debbie Tamborski, 06 March 2010 |
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