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DEATH
CERTIFICATE
MAGGIE FARMER
Date 02 November 1918
Cert: 36484
Place of Death: Voting Precinct: #24 Shelby, Pike Co., Ky.
Full Name: Maggie FARMER
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: no record
Age: about 24 years
Occupation: General housework
Birthplace: Knott Co., Ky.
Name of Father: James DIALS
Birthplace Father:
No record
Maiden name of Mother: " "
Birthplace Mother:
" "
Informant/Address: John FARMER, Shelbiana, Ky.
Filed: 08 November 1918
Registrar: J. C. Albright
Death Date: 02 November 1918
I hereby certify that I attended deceased from 28 October 1918, to
01 November 1918, that I last saw her alive on 01 November
1918, and that death occurred, on the date stated above, at 10
a.m.
Cause of Death: Influenza
Duration: 15 days
Contributory: Pneumonia
Signed/Address: E. P. Walters, 08 November 1918,
Pikeville
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: R. H. Ratliff
Date of Burial: 03 November 1918
Undertaker/Address: Reff. Castile, Shelbiana, Ky.
Transcribed by Debbie Tamborski, 28 February 2010 |
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