DEATH CERTIFICATE
GERTIE EVILINE FOGAN

Date    05 November 1911
Deathvol Vol:   1911
Cert: #  30289
Name:  Gertie Eviline FOGAN
Female, White, Single
Age:  01 years, 02 months, 3 days
Place of Death: Voting Pct. No. 4, Hazard, Perry Co., KY
Birth Date:  02 August 1911
Place of Birth:  Dossett, Tenn.
Father:  R. E. FOGAN                                                   Birthplace Father: Knoxville, Tenn.
Mother:  Annie LONG                                                    Birthplace Mother:  Dossett, Tenn.
Informant:  Not Listed
Death Date:  05 November 1911
Cause of Death:  Pertussus
Signed:  Taylor Hurst, M.D.
Burial Place:  Not Listed
Undertaker:  Not Listed
File Date: 20 December 1911
Transcribed by Debbie Tamborski, 24 June 2008