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DEATH
CERTIFICATE
JOSIE ANN PITTS
Date 04 May 1933
Cert: 13026
Place of Death: Voting Precinct: Caney, Breathitt Co,
Ky.
Full Name: Josie Ann PITTS
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: October 1848
Age: 84 years, 04 months, 04 days
Occupation: Housewife
Birthplace: Knott Co., Ky.
Name of Father: William PARKER
Birthplace Father: not known
Maiden name of Mother: Jiney SMITH
Birthplace Mother: not know
Informant/Address: W. M. PITTS, Quay, Ky.
Filed: 06 July 1933
Registrar: G. P. Beck, Deputy
Death Date: 04 May 1933
I hereby certify that I attended deceased from (blank), to
(blank), that I last saw h-- alive on (blank), and that death
occurred, on the date stated above at (blank)
Cause of Death: Chronic interstitial nephritis
Duration: 04 years
Contributory: (blank)
Signed/Address: (blank)
Length of residence at place of death: (blank)
Where was disease contracted if not at place of death?:
(blank)
Place of Burial or Removal: Ritchie fork grave yard
Date of Burial: 06 May 1933
Undertaker/Address: Maggie Craft, Guage, Ky.
Transcribed by Debbie Tamborski, 02 April 2010 |
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