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DEATH
CERTIFICATE
SAMUEL HENDRICKS
Date 31 October 1921
Cert: # 22217
Name: Samuel HENDRICKS
Place of Death: Voting Pct. #6, Knott Co., KY
Male, Colored
Birth Date: "Don't know"
Age: (blank)
Occupation: (blank)
Place of Birth: Alabama
Name of Father: (blank)
Birthplace Father: (blank)
Maiden Name of Mother: (blank)
Birthplace Mother: (blank)
Informant: George D. JENT, Smithsboro, Ky.
Death Date: 31 October 1921
Cause of Death: Dropped gun and killed himself accident
Signed: None
Burial Place: Shade Smiths
Date of Burial: 31 October 1921
Undertaker: Riley Smith, Smithsboro, Ky.
File Date: (blank)
Transcribed by Debbie Tamborski, 06 January 2009 |
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