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DEATH
CERTIFICATE
RANIE SMITH
Date 27 December 1915
Cert: 00035
Place of Death: Voting Precinct: No.1, Clay Co., Ky.
Full Name: Ranie SMITH
Sex, Color or Race, Marital Status: Female, White,
Single
Date of Birth: 21 March 1891
Age: 24 years, 09 months, 06 days
Occupation: (blank)
Birthplace: Knott Co., Ky.
Name of Father: Jeremiah SMITH
Birthplace Father: Letcher Co., Ky.
Maiden name of Mother: Lucinda KELLY
Birthplace Mother: Perry Co., Ky.
Informant/Address: (blank)
Filed: 28 December 1915
Registrar: Mrs. Wm. Rice(illegible)
Death Date: 27 December 1915
I hereby certify that I attended deceased from June 1914, to
December 1915, that I last saw her alive on 17 December 1915,
and that death occurred, on the date stated above, at 8 p.m.
Cause of Death: Rheumatism and complications
Duration: 01 years, 06 months
Contributory: Heart Duration:
01 years
Signed/Address: J. L. Anderson, 28 December 1915,
Manchester, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Jerry Smith's gravey.
Date of Burial: 28 December 1915
Undertaker/Address: J. B. Walker, Plank, Ky.
Transcribed by Debbie Tamborski, 26 February 2010 |
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