|
DEATH
CERTIFICATE
ADAM SMITH JR.
Date 04 October 1926
Cert: # 26003
Name: Adam SMITH Jr.
Place of Death: Voting Pct. Jones Fork, Knott Co., KY
Male, White
Birth Date: 13 September 1926
Age: 03 weeks
Occupation: (blank)
Place of Birth: Knott Co.
Name of Father: Adam SMITH
Birthplace Father: Knott Co.
Maiden Name of Mother: Bettie WICKER
Birthplace Mother: Knott Co.
Informant: Adam SMITH, Mousie, Ky.
Death Date: 04 October 1926
Cause of Death: Pirirentis [sic]
Signed: T. J. Chander, M.D.
Burial Place: Forks Four Mile Cemetery
Date of Burial: 06 October 1926
Undertaker: Silas Huff, Mousie
File Date: 23 October 1926
Transcribed by Debbie Tamborski, 16 February 2009 |
|