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DEATH
CERTIFICATE
MILLARD MAXIE
Date 04 February 1919
Cert: # 6984
Name: Millard MAXIE
Male, White, Single
Age: 13 years
Place of Death: Voting Precinct 2, Pine Top, Knott Co., KY
Birth Date: 06 June 1906
Occupation: (blank)
Place of Birth: Knott Co.
Name of Father: (blank)
Birthplace Father: Bill MAXIE
Maiden Name of Mother: Rhoda VANOVER
Birthplace Mother: Knott Co.
Informant: Richard MAXIE, Pinetop, Ky.
Death Date: 04 February 1919
Cause of Death: Influenza
Signed: (blank)
Burial Place: W. S. Amburgey
Date of Burial: 05 February 1919
Undertaker: W. J. Amburgey, Pine Top, Ky.
File Date: 10 February 1919
Transcribed by Debbie Tamborski, 14 November 2008 |
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