DEATH CERTIFICATE

 

Date  06 August 1922
Cert: #  18377 
Name:  Andesta HAGANS
Place of Death: Voting Pct. #3, Knott Co., KY
Female, Colored, Married
Birth Date:  1876
Age:  46 years
Occupation:   (blank)
Place of Birth:  Kentucky
Name of Father:  (blank) 
Birthplace Father:  (blank) 
Maiden Name of Mother: (blank)
Birthplace Mother:  (blank) 
Informant:  Jim HAGANS, Redfox, Ky.
Death Date:  06 August 1922 
Cause of Death:  Toncilitis 
Signed:  (blank)
Burial Place:  Wm. Breeding 
Date of Burial:  07 August 1922 
Undertaker:  (blank) 
File Date:  06 August 1922
Transcribed by Debbie Tamborski, 05 January 2009