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DEATH
CERTIFICATE
CARLISS PATRICK
Date 06 November 1934
Cert: 31416
Name: Carliss PATRICK
Place of Death: Voting Pct. Upper Ball, Knott Co., KY
Residence: Vest, Ky.
Length of residence: 06 days
Male, White, Single
Husband or Wife of: (blank)
Birth Date: (illegible) November 1934
Age: 06 days
Occupation: None
Place of Birth: Knott Co., Ky.
Name of Father: Adam PATRICK
Birthplace Father: Knott Co., Ky.
Maiden Name of Mother: Eva DOBSON
Birthplace Mother: Knott Co., Ky.
Informant: (blank)
Death Date: 06 November 1934
Cause of Death: Premature birth, no physician in
attendance
Signed: (blank)
Burial Place: (blank)
Date of Burial: 07 November 1934
Undertaker: (blank)
File Date: 26 November 1934
Transcribed by Debbie Tamborski, 23 July 2009
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