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DEATH
CERTIFICATE
SAMPSON SMITH
Date 23 June 1919
Cert: # 11920 See Cert. 18992 Original # 18992
Name: Sampson SMITH
Male, White, Single
Age: 69 years, 01 months, 13 days
Place of Death: Voting Precinct Cordia, Knott Co., KY
Birth Date: 10 May 1850
Occupation: Farmer
Place of Birth: Kentucky
Name of Father: John SMITH
Birthplace Father: Kentucky
Maiden Name of Mother: Willie COMBS
Birthplace Mother: Kentucky
Informant: (blank)
Death Date: 23 June 1919
Cause of Death: Endocarditis of the heart
Signed: M. F. Kelley, M.D.
Burial Place: Smith Cemetery
Date of Burial: 24 June 1919
Undertaker: John D. Smith, Cordia, Ky.
File Date: (blank)
Transcribed by Debbie Tamborski, 22 November 2008 |
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