DEATH CERTIFICATE
(stillbirth) SMITH

Date    16 September 1915
Deathvol Vol:   1915
Cert: #  28724
Name:  (stillbirth) SMITH
Male, White, Single
Age:  stillbirth
Place of Death: Voting Pct. No. 5, Knott Co., KY
Birth Date:  16 September 1915 
Place of Birth:  Ky.
Father:  Cleve SMITH                                                  Birthplace Father:  Ky.
Mother:  (Blank)                                                            Birthplace Mother:  Ky.
Informant:  G. C. SMITH, Cordia, Ky.
Death Date:  16 September 1915
Cause of Death:  Abortion
Signed:  (Blank)
Burial Place:  (Blank)
Undertaker:  (Blank)
File Date: 27 September 1915
Transcribed by Debbie Tamborski, 03 August 2008