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DEATH
CERTIFICATE
DALLY JACOBS
Date 23 December 1939
Cert: 30704
Name: Dally JACOBS
Place of Death: Voting Pct. Upper Caney, Knott Co., KY
Residence: Hollybush, Ky.
Length of residence: (blank)
Female, White, Single
Husband or Wife of: (blank)
Birth Date: 23 December 1939
Age: Stillborn
Occupation: (blank)
Place of Birth: Kentucky
Name of Father: Woodrow JACOBS
Birthplace Father: Kentucky
Maiden Name of Mother: Corsie SMITH
Birthplace Mother: Kentucky
Informant: Woodrow JACOBS, Hollybush, Ky.
Death Date: 23 December 1939
Cause of Death: (blank)
Signed: Frankie S. Jacobs, Midwife, Pippapass, Ky.
Burial Place: J. P. Slone Grave
Date of Burial: 24 December 1939
Undertaker: (blank)
File Date: 04 January 1940
Registrar: E. J. Owens
Transcribed by Debbie Tamborski, 16 November 2009 |
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