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DEATH
CERTIFICATE
Mrs. SERENA JONES
Date 26 August 1917
Cert: 25711
Place of Death: Voting Precinct: No. 7 Whitesburg,
Dongola P.O., Letcher Co., Ky.
Full Name: Mrs. Serena JONES
Sex, Color or Race, Marital Status: Female, White, Widow
Date of Birth: (blank)
Age: 67 years
Occupation: none
Birthplace: Knott Co., Ky.
Name of Father:
Not Known
Birthplace Father:
" "
Maiden name of Mother: "
"
Birthplace Mother:
" "
Informant/Address: Kerney ADAMS, Dongola, Ky.
Filed: (blank)
Registrar: (blank)
Death Date: 26 August 1917
I hereby certify that I attended deceased from 20 August 1917, to
26 August 1917, that I last saw her alive on 19 August 1917,
and that death occurred, on the date stated above, at 8 a.m.
Cause of Death: Typhoid Fever
Duration: (blank)
Contributory: (blank)
Signed/Address: Bert C. Back, M.D., 27 August 1917,
Whitesburg, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Dongola, Ky.
Date of Burial: 27 August 1917
Undertaker/Address: R. N. Swisher, Whitesburg, Ky.
Transcribed by Debbie Tamborski, 28 February 2010 |
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