DEATH CERTIFICATE

CHRIS COLLINS

Date  06 July 1921
Cert: #  15470
Name:  Chris COLLINS
Place of Death: Voting Pct. #5, Knott Co., KY
Male, White
Birth Date:  21 October 1919
Age:  01 years,  09 months
Occupation:  non
Place of Birth:  Ky.
Name of Father:  Fielden COLLINS
Birthplace Father:  Ky.
Maiden Name of Mother:  Mary SINGLETON
Birthplace Mother:  Ky.
Informant:  Samuel SMITH, Ritchie, Ky.
Death Date:  06 July 1921
Cause of Death:  Diree [sic]
Signed:  (blank)
Burial Place:  Samuel Smith
Date of Burial:  07 July 1921
Undertaker:  (blank)
File Date:  (blank)
Transcribed by Debbie Tamborski, 12 December 2008