DEATH CERTIFICATE

MALORY COMBS

Date    25 October 1917
Cert: # 28258
Name: Malory COMBS
Female, Colored, Single
Age: 15 years, 06 months
Place of Death: Voting Precinct #6, Knott Co., KY
Birth Date: 25 April 1902
Place of Birth: Knott Co., Ky.
Father: John COMBS                                                  Birthplace Father: Kentucky
Mother: Eliza FRANCIS                                                       Birthplace Mother: Kentucky
Informant: Casa COMBS, Smithsboro, Ky.
Death Date: 25 October 1917
Cause of Death: Tuberculosis of the lungs
Signed:  F. C. Roark, M.D.
Burial Place: Fielden Johnsons
Undertaker: John Combs, Cody, Ky.
File Date: 15 October 1917
Transcribed by Debbie Tamborski, 02 November 2008