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DEATH
CERTIFICATE
POLINA SMITH
Date 10 June 1911
Deathvol
Vol: 1911
Cert: # 15650
Name: Polina SMITH
Female, White, Married
Age: 53 years, 28 days
Place of Death: Voting Pct No. #6, Knott Co., KY
Birth Date: 10 June 1911
Place of Birth: Knott Co., KY
Father: Jeremiah L. COMBS
Mother: Sarah COMBS
Informant: Shade SMITH
Death Date: 10 June 1911
Cause of Death: Chronic gastritis of the stomach,
cystitis and malignant sarcoma of kidney
Signed: M.F. Kelley, M.D.
Burial Place: Smiths Cem.
Undertaker: Shade Smith
File Date: 10 June 1911
Transcribed by Debbie Tamborski, 3 May 2008 |
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