DEATH CERTIFICATE

POLLEY HOWARD

Date   26 March 1916
Cert: #  Duplicate 25614 Original 12031
Name:  Polley HOWARD
Female, White
Age: 05 years, 00 months, 06 days
Place of Death: Vot. Precinct Quicksand, Decoy, Knott Co., KY
Birth Date:  20 March 1911
Occupation:  (blank)
Place of Birth:  Knott Co., Ky.
Name of Father:  Joseph HOWARD
Birthplace Father:  Knott Co., Ky.
Maiden Name of Mother:  Margaret SLUSHER
Birthplace Mother:  Kentucky
Informant:  James STACY, Decoy, Ky.
Death Date:  26 March 1916
Cause of Death:  (blank)
Signed:  (blank)
Burial Place:  (blank)
Date of Burial:  (blank)
Undertaker:  (blank)
File Date:  29 March 1916
Transcribed by Debbie Tamborski, 12 November 2008