DEATH CERTIFICATE

OMAH FIELDS

Date    19 April 1917
Cert: #  14741 
Name:  Omah FIELDS
Female, White, Child
Age:   08 months, 21 days
Place of Death: Voting Precinct #6, Knott Co., KY  
Birth Date:  28 July 1916                                                  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:  19 April 1917 
Cause of Death:  Fits caused by worms 
Signed:  (blank)
Burial Place:  Davis Franklins                                                Date of Burial:  19 April 1917
Undertaker:  Sallie Mullins, Smithsboro, Ky.
File Date:  19 May 1917
Transcribed by Debbie Tamborski, 07 November 2008