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DEATH
CERTIFICATE
CLIDE SMITH
Date 17 February 1927
Cert: # 04174
Name: Clide SMITH
Place of Death: Voting Pct. #16 Cordia, Knott Co., KY
Male, White, Single
Birth Date: (blank)
Age: 12 years, 01 months, 07 days
Occupation: School Boy
Place of Birth: Ky.
Name of Father: Cleaveland SMITH
Birthplace Father: Ky.
Maiden Name of Mother: Alice STACY
Birthplace Mother: Ky.
Informant: (blank)
Death Date: 17 February 1927
Cause of Death: Influenza Contributory:
Lobar pneumonia
Signed: M. F. Kelley, M.D.
Burial Place: Smith Cemetery
Date of Burial: 18 February 1927
Undertaker: Cleaveland Smith, Cordia, Ky.
File Date: (blank)
Transcribed by Debbie Tamborski, 17 February 2009 |
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