DEATH CERTIFICATE

SUSIE B. SMITH

Date  28 June 1926
Cert: #  15761 
Name:  Susie B. SMITH 
Place of Death: Voting Pct. Littcarr, Knott Co., KY
Female, White, Widow
Birth Date:  14 October 1841 
Age:  84 years, 08 months, 14days
Occupation:  House keeping 
Place of Birth:  Knott Co., Ky.
Name of Father:  Ambrose AMBURGEY
Birthplace Father:  North Carolina 
Maiden Name of Mother:  Rebecca FRANCIS
Birthplace Mother:  Knott Co., Ky. 
Informant:  W. B. SMITH, Littcarr, Ky.
Death Date:  28 June 1926 
Cause of Death:  Heart failure 
Signed:  (blank)
Burial Place:  G. W. Amburgey Cemetery 
Date of Burial:  29 June 1926 
Undertaker:  (blank) 
File Date:  06 July 1926 
Transcribed by Debbie Tamborski, 19 February 2009