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DEATH
CERTIFICATE
FREDDIE NATHANIEL CLARK
Date 24 February 1926
Cert: # 4598
Name: Freddie Nathaniel CLARK
Place of Death: Voting Pct. #15, Knott Co., KY
Male, Colored, Single
Birth Date: 08 August 1924
Age: 01 years, 06 months, 16 days
Occupation: Non
Place of Birth: Knott Co., Ky.
Name of Father: Jas Dillard CLARK
Birthplace Father: Ky.
Maiden Name of Mother: Lucile ROBINSON
Birthplace Mother: Ky.
Informant: W. B. Hopkins, Anco, Ky.
Death Date: 24 February 1926
Cause of Death: Influenza refused medicine
Contributory: Broncho pneumonia
Signed: W. B. Hopkins, M.D.
Burial Place: (blank)
Date of Burial: (blank)
Undertaker: (blank)
File Date: 10 March 1926
Transcribed by Debbie Tamborski, 12 December 2008 |
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