DEATH CERTIFICATE
CICERO FUGATE

Date    06 November 1911
Deathvol Vol:   1911
Cert: #  30292
Name:  Cicero FUGATE
Male, White, Single
Age:  17 years, 21 days
Place of Death: Voting Pct. Lost Creek, Perry Co., KY
Birth Date:  15 October 1894
Place of Birth:  Kentucky
Father:  J. H. FUGATE, Jr.                                                      Birthplace Father: Kentucky
Mother:  Naoma NOBLE                                                    Birthplace Mother:  Kentucky
Informant:  J. H. FUGATE, Jr.
Death Date:  06 November 1911
Cause of Death:  Pulmonary tuberculosis
Signed:  J. H. Fugate, member of the family
Burial Place:  Sixteen
Undertaker:  J. H. Fugate, Father of child
File Date: 22 December 1911
Transcribed by Debbie Tamborski, 24 June 2008