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DEATH
CERTIFICATE
POLLY COBERN
Date 12 June 1930
Cert: # 14789
Name: Polly COBERN
Place of Death: Voting Pct. #4, Knott Co., KY
Female, White, Single
Husband or Wife of: Silas SMITH
Birth Date: 12 April 1888
Age: 42 years, 02 months, 00 days
Occupation: Housework
Place of Birth: Ky.
Name of Father: Joe COBERN
Birthplace Father: Ky.
Maiden Name of Mother: Sally TURNER
Birthplace Mother: Ky.
Informant: Silas SMITH, Elmrock, Ky.
Death Date: 12 June 1930
Cause of Death: Death resulted from birth of child.
No physician present at time of death.
Signed: (blank)
Burial Place: Patton Fork Cem.
Date of Burial: 13 June 1930
Undertaker: W. M. Compton, Elmrock, Ky.
File Date: (blank)
Transcribed by Debbie Tamborski, 23 June 2009 |
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