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DEATH
CERTIFICATE
ORBIN JACOBS
Date 16 November 1935
Cert: 27737
Name: Orbin JACOBS
Place of Death: Voting Pct. Upper Caney,
Pippapass, Knott Co., KY
Residence: (blank)
Length of residence: (blank)
Male, White, Single
Husband or Wife of: (blank)
Birth Date: 10 November 1935
Age: 06 days
Occupation: (blank)
Place of Birth: Pippapass, Ky.
Name of Father: (blank)
Birthplace Father: (blank)
Maiden Name of Mother: Frances JACOBS
Birthplace Mother: Pippapass, Ky.
Informant: Dora GIBSON, Pippapass, Ky.
Death Date: 16 November 1935
Cause of Death: The mother was in poor health
which caused the premature birth
Signed: Dora Belle Gibson, Midwife, Pippapass, Ky.
Burial Place: Owens Cemetery
Date of Burial: 17 November 1935
Undertaker: Tom Jacobs, Pippapass, Ky.
File Date: 22 November 1935
Transcribed by Debbie Tamborski, 13 August 2009 |
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