DEATH CERTIFICATE

DELLA FIELDS

Date    22 June 1913
Deathvol Vol:   1913
Cert: # 16335
Name: Della FIELDS
Female, White, Single
Age: 14 years, 04 months, 00 days
Place of Death: Voting Pct. No. 6, Knott Co., KY
Birth Date: 22 February 1899
Place of Birth: Perry Co., Ky.
Father: Jack FIELDS                                                   Birthplace Father: Perry Co., Ky.
Mother: Manda COOTS                                                      Birthplace Mother: Leslie Co., Ky.
Informant: Jack FIELDS, Smithsboro, Ky.
Death Date: 22 June 1913
Cause of Death: Flux     Contributory: Measles
Signed:  G. D. Ison, M.D.
Burial Place: Combs Grave
Undertaker: Jack Fields, Smithsboro, Ky.
File Date: 22 June 1913
Transcribed by Debbie Tamborski, 22 July 2008