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DEATH
CERTIFICATE
ELLIS JACOBS
Date 29 June 1919
Cert: # 18993
Name: Ellis JACOBS
Male, White, Single
Age: 01 months, 18 days
Place of Death: Voting Precinct #7 Caney, Knott Co., KY
Birth Date: 11 May 1919
Occupation: Nothing
Place of Birth: Knott Co., Ky.
Name of Father: Benjamin JACOBS
Birthplace Father: Ky.
Maiden Name of Mother: Dora SLONE
Birthplace Mother: Ky.
Informant: Tolby JACOBS, Raven, Ky.
Death Date: 29 June 1919
Cause of Death: Illieo colitis
Signed: Chas. Sturgill, M.D.
Burial Place: Alice Slone Cemetery
Date of Burial: 30 June 1919
Undertaker: Tolby Jacobs
File Date: 09 July 1919
Transcribed by Debbie Tamborski, 12 November 2008 |
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