DEATH CERTIFICATE
(stillbirth) COOK

Date    12 October 1915
Deathvol Vol:   1916
Cert: #  80
Name:  (stillbirth) COOK
White, Married (transcribed as written)
Age:  (Blank)
Place of Death: Voting Pct. No. 6, Smithsboro, Knott Co., KY
Birth Date:  12 October 1915                                    Occupation:  Farmer (transcribed as written)
Place of Birth:  (Blank)
Father:  Miles COOK                                                   Birthplace Father:  Floyd Co., Ky.
Mother:  Etta COOK                                                       Birthplace Mother:  Letcher Co., Ky.
Informant:  (Blank)
Death Date:  12 October 1915
Cause of Death:  (?miseriey?)
Signed:  (Blank)
Burial Place:  E. L. Toliver
Undertaker:  Grover Hall, Dirk, Ky.
File Date: (Blank)
Transcribed by Debbie Tamborski, 01 August 2008