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DEATH
CERTIFICATE
PAUL TRUMAN FUGATE
Date 28 April 1917
Cert: 15430
Place of Death: Voting Precinct: No. 3, Perry Co., Ky.
Full Name: Paul Truman FUGATE
Sex, Color or Race, Marital Status: Male, White, Infant
Date of Birth: 31 March 1917
Age: 29 days
Occupation: (blank)
Birthplace: Knott Co., Ky.
Name of Father: Elhanon FUGATE
Birthplace Father: Dwarf, Ky.
Maiden name of Mother: America FITCH
Birthplace Mother: Kentucky
Informant/Address: Anna FUGATE, Dwarf, Ky.
Filed: 02 May 1917
Registrar: E. B. Owens
Death Date: 28 April 1917
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: No medical attention
Duration: (blank)
Contributory: (blank)
Signed/Address: (blank)
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Fugate Cemetery (illegible)
Date of Burial: 29 April 1917
Undertaker/Address: none
Transcribed by Debbie Tamborski, 28 February 2010 |
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