DEATH CERTIFICATE
MARY SMITH

Date    17 September 1911
Deathvol Vol:   1911
Cert: #  24256
Name:  Mary SMITH
Female, White, Single
Age:  3 years, 11 months, 27 days
Place of Death: Voting Pct. No. 3, Perry Co., KY
Birth Date:  20 September 1907
Place of Birth:  Ary, Ky.
Father:  Hoye SMITH                                                   Birthplace Father: Ary, Ky.
Mother:  Margaret COMBS                                              Birthplace Mother:  Ary, Ky.
Informant:  Margaret SMITH
Death Date:  17 September 1911
Cause of Death:  Diptheria
Signed:  S. M. Richie, M.D.
Burial Place:  Smith Cemetery
Undertaker:  Richard Smith
File Date: 17 September 1911
Transcribed by Debbie Tamborski, 25 June 2008