DEATH CERTIFICATE

POLLEY MCINTOSH

Date  03 May 1926
Cert: #  13695 
Name:  Polley McINTOSH
Place of Death: Voting Pct. Upper Ball, Knott Co., KY
Female, White, Single
Birth Date:  02 May 1904
Age: 22 years, 02 days
Occupation:  Housework
Place of Birth:  Breathitt Co., Ky.
Name of Father:  Lewis McINTOSH 
Birthplace Father:  Breathitt Co., Ky. 
Maiden Name of Mother:  Nervey NOBLE
Birthplace Mother:  Breathitt Co., Ky. 
Informant:  Daniel McINTOSH, Vest, Ky.
Death Date:  03 May 1926
Cause of Death:  Comited sueside gunshot [sic]  
Signed:  No physician in attendance
Burial Place:  Messer Grave 
Date of Burial:  05 May 1926 
Undertaker:  Dan Gipson, Vest, Ky. 
File Date:  05 May 1926 
Transcribed by Debbie Tamborski, 16 January 2009