DEATH CERTIFICATE

SUSAN HALE

Date   21 June 1935
Cert:  15150 
Name:  Susan HALE
Place of Death: Voting Pct. Middle Carr #3, Knott Co., KY
Residence:  Cody, Ky. 
Length of residence: (blank)
Female, White, Widowed
Husband or Wife of:  John HALE
Birth Date:  18 November 1859 
Age: 75 years, 07 months, 03 days
Occupation:  House wife 
Place of Birth:  Cody, Ky.
Name of Father:  Lewis BACK
Birthplace Father:  Letcher Co., Ky. 
Maiden Name of Mother:  Polyan BROWN
Birthplace Mother:  Letcher Co., Ky. 
Informant:  W. M. HALE, Cody, Ky. 
Death Date:  21 June 1935 
Cause of Death:   Heart Failure 
Signed:  (blank)
Burial Place:  Blair Cemetery
Date of Burial:  22 June 1935
Undertaker:  (blank)
File Date:  25 June 1935
Transcribed by Debbie Tamborski, 12 August 2009