DEATH CERTIFICATE

JEFFERSON FUGATE

Date  21 March 1912
Cert: #  8363 
Name:  Jefferson FUGATE 
Male, White, Single
Age:  25 years, 00 months, 00 days
Place of Death: Voting Precinct Lost Creek, Perry Co., KY
Birth Date:  21 March 1887 
Occupation:  Farming 
Place of Birth:  Kentucky 
Name of Father:  John FUGATE 
Birthplace Father:  Kentucky 
Maiden Name of Mother:  (blank) 
Birthplace Mother:  Kentucky 
Informant:  Elijah NEACE, Ned, Ky. 
Death Date:  21 March 1912 
Cause of Death:  Consumption 
Signed:   John Fugate, Father of son
Burial Place:  Caney graveyard 
Date of Burial:   22 March 1912 
Undertaker:  Gran Noble, Ned, Ky. 
File Date:  24 March 1912 
Transcribed by Debbie Tamborski, 02 December 2008