DEATH CERTIFICATE
(stillbirth) POLLY

Date    02 July 1915
Deathvol Vol:   1915
Cert: #  17574
Name:  (stillbirth) POLLY
Male, White
Age:  stillbirth
Place of Death: Voting Pct. Hindman, Knott Co., KY
Birth Date:  02 July 1915                        
Place of Birth:  Knott
Father:  Joe POLLY                                                     Birthplace Father:  Knott
Mother:  Ellen TAYLOR                                                    Birthplace Mother:  Knott
Informant:  Joe POLLY, Hindman, Ky.
Death Date:  02 July 1915
Cause of Death:  unknown--Stillbirth
Signed:  Jane Childers, M.D.
Burial Place:  (Blank)
Undertaker:  (Blank)
File Date: 05 August 1915
Transcribed by Debbie Tamborski, 03 August 2008