DEATH CERTIFICATE
(stillborn) SMITH

Date    11 March 1912
Deathvol 
Vol:   1912
Cert: #  7735
Name:  (stillborn) SMITH
Male, White, Single
Age: 
Place of Death: Voting Pct No. 6, Knott Co., KY
Birth Date:  11 March 1912
Place of Birth:  Knott Co., Ky.
Father:  G. C. SMITH                                                   Birthplace Father: Knott Co., Ky.
Mother:  Alise SMITH                                                 Birthplace Mother:  Knott Co., Ky.
Informant:  Mary Ann ADAMS
Death Date:  11 March 1912 
Cause of Death:  Stillbirth
Signed:  J. W. Duke , M.D.
Burial Place:  Smiths Cemetery 
Undertaker:  G. C. Smith
File Date: 12 March 1912
Transcribed by Debbie Tamborski, 18 June 2008