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DEATH
CERTIFICATE
JACK NELSON PRIDEMORE
Date 17 August 1936
Cert: 22430
Name: Jack Nelson PRIDEMORE
Place of Death: Voting Pct. Upper Caney,
Pippapass, Knott Co., KY
Residence: (blank)
Length of residence: (blank)
Male, White, Single
Husband or Wife of: (blank)
Birth Date: 16 November 1934
Age: 21 months, 01 days
Occupation: At home
Place of Birth: Hazard, Ky.
Name of Father: Ray PRIDEMORE
Birthplace Father: Pippapass, Ky.
Maiden Name of Mother: Dortha KILGORE
Birthplace Mother: Hindman, Ky.
Informant: George ELIAS, Hindman, Ky.
Death Date: 17 August 1936
Cause of Death: Entr Colitis
Signed: M. F. Kelley, M.D., Hindman, Ky.
Burial Place: (illegible)
Date of Burial: (illegible)
Undertaker: Ray Pridemore, Mallie, Ky.
File Date: 05 September 1936
Registrar: E. J. Owens
Transcribed by Debbie Tamborski, 19 September 2009 |
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