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DEATH
CERTIFICATE
ALEX JACOBS
Date 11 November 1921
Cert: # 27289
Name: Alex JACOBS
Place of Death: Voting Pct. #18 Upper Caney, Knott Co., KY
Male, White, Widowed
Birth Date: (blank)
Age: (blank)
Occupation: Farming
Place of Birth: Kentucky
Name of Father: Henry C. JACOBS
Birthplace Father: Kentucky
Maiden Name of Mother: Martha SLONE
Birthplace Mother: Kentucky
Informant: Napoleon JACOBS, Pippapass, Ky.
Death Date: 11 November 1921
Cause of Death: Gunshot wound
Signed: M. F. Kelley, M.D.
Burial Place: J. P. Slone Cemetery
Date of Burial: 12 November 1921
Undertaker: Napoleon Jacobs, Pippapass, Ky.
File Date: 25 December 1921
Transcribed by Debbie Tamborski, 13 January 2009 |
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