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DEATH
CERTIFICATE
MADISON FIELDS
Date 17 August 1917
Cert: # 22978
Name: Madison FIELDS
Male, White, Child
Age: 02 years, 03 months, 22 days
Place of Death: Voting Precinct #6, Knott Co., KY
Birth Date: 25 May 1915
Occupation: (blank)
Place of Birth: Knott Co.
Name of Father: Samuel FIELDS
Birthplace Father: Letcher Co.
Maiden Name of
Mother: Sallie MULLINS
Birthplace Mother: Knott Co.
Informant: Valentine MULLINS, Smithsboro, Ky.
Death Date: 17 August 1917
Cause of Death: Fits caused by worms
Signed: (blank)
Burial Place: Davis Franklins
Date of Burial: 18 August 1917
Undertaker: Valentine Mullins, Smithsboro, Ky.
File Date: 18 August 1917
Transcribed by Debbie Tamborski, 07 November 2008 |
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