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DEATH
CERTIFICATE
CEPUL MORIS
Date 06 March 1920
Cert: 09959
Place of Death: Voting Precinct: Rowan Co., Ky.
Full Name: Cepul MORIS
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: 1893
Age: 27 years
Occupation: Farmer
Birthplace: Not Co., Ky.
Name of Father: John MORIS
Birthplace Father: Not Co., Ky.
Maiden name of Mother: Rachel TRIPLET
Birthplace Mother: Not Co., Ky.
Informant/Address: J. H. MORIS, Paragon, Ky.
Filed: 07 March 1920
Registrar: Eva Caudell
Death Date: 06 March 1920
I hereby certify that I attended deceased from never attended
him, to (blank), that I last saw h-- alive on (blank), and
that death occurred, on the date stated above, at 3 p.m.
Cause of Death: Gun shot wound. This man was in
good health and got killed by gun shot
Duration: (blank)
Contributory: (blank)
Signed/Address: A. L. Blair, M.D., 06
March 1920, Morehead, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Mt. Hope Cemetery
Date of Burial: 08 March 1920
Undertaker/Address: J. H. Moris, Paragon, Ky.
Transcribed by Debbie Tamborski, 06 March 2010 |
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