DEATH CERTIFICATE

VALIS COX

Date    16 November 1914
Deathvol Vol:   1914
Cert: # 29233
Name: Valis COX
Male, White, Single
Age: 2 years, 9 months, 4 days
Place of Death: Voting Pct. Jones Fork, Knott Co., KY
Birth Date: 12 January 1911
Place of Birth: Ky.
Father: Winfred COX                                                  Birthplace Father: Ky.
Mother: Laura GEARHART                                                    Birthplace Mother: Ky.
Informant: (Blank)
Death Date: 16 November 1914
Cause of Death: Burn (accidental)
Signed:  T. J. Chandler, M.D.
Burial Place: Chafins Cemetery
Undertaker: (Blank)
File Date: 25 November 1914
Transcribed by Debbie Tamborski, 24 July 2008