DEATH CERTIFICATE
AMOS JACOBS

Date    08 November 1914
Deathvol Vol:   1914
Cert: #  29229
Name:  Amos JACOBS
Male, White, Single
Age:  3 years, 9 months, 29 days
Place of Death: Voting Pct. No. 7, Hollybush, Knott Co., KY
Birth Date:  10 January 1911                          
Place of Birth:  Knott Co., Ky.
Father:  Leonard JACOBS                                                   Birthplace Father:  Ky.
Mother:  Elefair SLONE                                                       Birthplace Mother:  Ky.
Informant:  Thomas JACOBS, Raven, Ky.
Death Date:  08 November 1914
Cause of Death:  Diptheria
Signed:  T. J. Chandler, M.D.
Burial Place:  Alice Slone Cemetery
Undertaker:  Thomas Jacobs, Raven, Ky.
File Date: 15 November 1914
Transcribed by Debbie Tamborski, 27 July 2008