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DEATH
CERTIFICATE
SAMPSON SMITH
Date 24 June 1919
Cert: # 18992 See Cert. 11920 Duplicate #11920
Name: Sampson SMITH
Male, White, (smudge)
Age: 66
Place of Death: Voting Precinct #5 Cordia, Knott Co., KY
Birth Date: 1854
Occupation: Farmer
Place of Birth: Kentucky
Name of Father: John SMITH
Birthplace Father: Kentucky
Maiden Name of Mother: Willie COMBS
Birthplace Mother: Kentucky
Informant: G. C. YOUNG, Elic, Ky.
Death Date: 24 June 1919
Cause of Death: Dropsy
Signed: M. F. Kelley, M.D.
Burial Place: Gearheart Cemetery
Date of Burial: 25 June 1919
Undertaker: (blank) Cordia, Ky.
File Date: (blank)
Transcribed by Debbie Tamborski, 22 November 2008 |
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