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DEATH
CERTIFICATE
WILLIS JACOBS
Date 08 July 1938
Cert: 20222
Name: Willis JACOBS
Place of Death: Voting Pct. Lower Caney #12, Knott Co., KY
Residence: Pippapass, Ky.
Length of residence: (blank)
Male, White, Single
Husband or Wife of: (blank)
Birth Date: 06 February 1917
Age: 21 years, 05 months, 02 days
Occupation: Farmer
Place of Birth: Holly Bush, Ky.
Name of Father: Thomas JACOBS
Birthplace Father: Lackey, Ky.
Maiden Name of Mother: Bethanie OWENS
Birthplace Mother: Raven, Ky.
Informant: Odis JACOBS, Pippapass, Ky.
Death Date: 08 July 1938
Cause of Death: Generalized peritonitis
Contributory: Ruptured appendix
Name of operation: drainage
Signed: Philip Bress, M.D., Lackey, Ky.
Burial Place: Pippapass
Date of Burial: 10 July 1938
Undertaker: G. D. Ryan, Martin, Ky.
File Date: July 1938
Registrar: E. J. Owens per B. Carns
Transcribed by Debbie Tamborski, 31 October 2009 |
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