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DEATH
CERTIFICATE
JOHN MORIS
Date 27 January 1919
Cert: 03948
Place of Death: Voting Precinct: No. #3
Morehead, Rowan Co., Ky.
Full Name: John MORIS
Sex, Color or Race, Marital Status: Male, White, (blank)
Date of Birth: 07 October 1855
Age: 64 years
Occupation: Farmer
Birthplace: Knot Co., Ky.
Name of Father: Zack MORIS
Birthplace Father: Knot Co., Ky.
Maiden name of Mother: Triplet
Birthplace Mother: Knot Co., Ky.
Informant/Address: J. H. his mark Morris, Paragon, Ky.
Filed: 28 January 1919
Registrar: Eve (Illegible)
Death Date: 27 January 1919
I hereby certify that he was sick from 15 January 1919, to 27
January 1919, that I last saw never had a doctor, and that
death occurred, on the date stated above, at 7 p.m.
Cause of Death: Pneumonia fever following influenza
Duration: (blank)
Contributory: Influenza
Signed/Address: A. L. Blair, M.D., 28
January 1919, Morehead, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Morris Cemetery (illegible)
Date of Burial: 29 January 1919
Undertaker/Address: J. H. Morris, Paragon, Ky.
Transcribed by Debbie Tamborski, 05 March 2010 |
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