DEATH CERTIFICATE

(Stillborn) HOLLIDAY

Date   04 November 1917
Cert: #  30914
Name: (Stillborn) HOLLIDAY
Female, Color, Marital Status:  (blank)
Age: (blank)
Place of Death: Voting Precinct Hindman, Knott Co., KY
Birth Date:  04 November 1917
Occupation:  (blank)
Place of Birth:  Knott Co.
Name of Father:  Monroe HOLLIDAY
Birthplace Father:  Perry Co.
Maiden Name of Mother:  Lucinda FIELDS
Birthplace Mother:  Knott Ky.
Informant:  (blank)
Death Date:  04 November 1917
Cause of Death:  unknown
Signed:  Sally B. Simpson
Burial Place:  Holliday
Date of Burial:  04 November 1917
Undertaker:  (blank)
File Date:  08 November 1917
Transcribed by Debbie Tamborski, 12 November 2008