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DEATH
CERTIFICATE
ADIONNA ISAACS
Date 04 October 1924
Cert: 07232
Place of Death: Vot. Precinct: #9, Shelby Gap, Letcher
Co., Ky.
Full Name: Adionna Isaacs
Sex, Color or Race, Marital Status: Female, White,
Single
Date of Birth: 27 July 1912
Age: 12 years, 02 months, 07 days
Occupation: At home
Birthplace: Knott Co., Ky.
Name of Father: Jermon ISAACS
Birthplace Father: Ky.
Maiden name of Mother: Cosby MULLINS
Birthplace Mother: Ky.
Informant/Address: W. D. RATLIFF, Shelby Gap, Ky.
Filed: 05 October 1924
Registrar: C. C. Greer
Death Date: 04 October 1924
I hereby certify that I attended deceased from (blank), to
(blank), that I last saw h-- alive on (blank), and that death
occurred, on the date stated above, at (blank)
Cause of Death: Pneumonia following blood poisoning
according to Dr. Chas Johnson, Burdine, Ky.
Duration: (blank)
Contributory: (blank)
Signed/Address: (blank)
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Darton, Ky.
Date of Burial: 06 October 1924
Undertaker/Address: Family, Shelby Gap, Ky.
Transcribed by Debbie Tamborski, 20 March 2010 |
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