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DEATH
CERTIFICATE
GEROME SMITH
Date 23 July 1939
Cert: 18109
Name: Gerome SMITH
Place of Death: Voting Pct. Mousie, Knott Co., KY
Residence: Mousie, Ky.
Length of residence: (blank)
Male, White, Child
Husband or Wife of: (blank)
Birth Date: 23 January 1939
Age: 06 months
Occupation: (blank)
Place of Birth: Mousie, Ky.
Name of Father: Merland SMITH
Birthplace Father: Mousie, Ky.
Maiden Name of Mother: Ema BERRY
Birthplace Mother: Mousie, Ky.
Informant: Merland SMITH, Mousie, Ky.
Death Date: 23 July 1939
Cause of Death: Pneumonia
Signed: N. N. Collins, M.D., Lackey, Ky.
Burial Place: 4 Mile Cemetery
Date of Burial: 25 July 1939
Undertaker: John F. Baley
File Date: 26 July 1939
Registrar: J. F. Combs
Transcribed by Debbie Tamborski, 21 November 2009 |
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