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DEATH
CERTIFICATE
BETSYAN FUGATE
Date 02 April 1929
Cert: 11205
Place of Death: Voting Pct: No. 23 Breathitt Co., Ky.
Full Name: Betsyan FUGATE
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 20 January 1869
Age: 59 years, Dont know
Occupation: Hous work [sic]
Birthplace: Knott Co.
Name of Father: Manford STACY
Birthplace Father: Ky
Maiden name of Mother: Lunah STACY
Birthplace Mother: Ky.
Informant/Address: Hiram FUGATE, Lunah, Ky.
Filed: 04 April 1929
Registrar: A. D. Russell
Death Date: 02 April 1929
I hereby certify that I attended deceased from (blank), to
(blank), that I last saw h-- alive on (blank), and that death
occurred, on the date stated above at (blank)
Cause of Death: Cancer in bouls [sic]
Duration: (blank)
Contributory: (blank)
Signed/Address: none
Place of Burial or Removal: Stacy Cemetery
Date of Burial: 03 April 1929
Undertaker/Address: none Private (?Pural?)
Transcribed by Debbie Tamborski, 27 March 2010 |
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