DEATH CERTIFICATE

SALLEY FUGATE

Date  20 June 1912
Cert: #  16319 
Name:  Salley FUGATE 
Female, White, Single
Age:  55 years
Place of Death: Voting Precinct Lost Creek, Perry Co., KY
Birth Date:  20 June 1855 
Occupation:  Farming and stock raising 
Place of Birth:  Kentucky 
Name of Father:  William FUGATE 
Birthplace Father:  Kentucky 
Maiden Name of Mother:  Polley NOBLE 
Birthplace Mother:  Kentucky 
Informant:  Judge I. FUGATE, Ned, Ky. 
Death Date:  20 June 1912 
Cause of Death:  Dropsy 
Signed:  Judge I. Fugate, member of family
Burial Place:  (???) Fork 
Date of Burial:  21 June 1912 
Undertaker:  Judge Fugate, acting, Ned, Ky. 
File Date:  11 August 1912 
Transcribed by Debbie Tamborski, 02 December 2008