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DEATH
CERTIFICATE
SAMUEL FRANCIS
Date 18 September 1922
Cert: # 22517
Name: Samuel FRANCIS
Place of Death: Voting Pct. Old Carr, Dirk, Knott Co., KY
Male, White, Married
Birth Date: 25 June 1843
Age: 79 years, 02 months, 23 days
Occupation: Farmer
Place of Birth: Knott Co., Ky.
Name of Father: Simeon FRANCIS
Birthplace Father: Va. or N. Car. (transcribed as
written)
Maiden Name of Mother: Cassie B. SMITH
Birthplace Mother: Ky.
Informant: W. T. FRANCIS, Dirk, Ky.
Death Date: 18 September 1922
Cause of Death: Reguritant Valvular Lesion of the Heart
Contributory: Pneumonia
Signed: F. C. Roark, M.D.
Burial Place: (blank)
Date of Burial: (blank)
Undertaker: (blank)
File Date: (blank)
Transcribed by Debbie Tamborski, 30 December 2008 |
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