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DEATH
CERTIFICATE
SHAD STACY
Date 15 January 1923
Cert: Original # 02156 Duplicate # 02160
Name: Shad STACY
Place of Death: Voting Pct. #1 Hindman, Knott Co., KY
Male, White, Married
Birth Date: 10 April 1854
Age: 68 years, 09 months, 05 days
Occupation: Farmer
Place of Birth: Kentucky
Name of Father: John STACY
Birthplace Father: Kentucky
Maiden Name of Mother: Beccy MULLENS
Birthplace Mother: Kentucky
Informant: (blank)
Death Date: 15 January 1923
Cause of Death: Tuberculosis of bowles [sic]
Signed: M. F. Kelley, M.D.
Burial Place: Toliver Cemetery
Date of Burial: 16 January 1923
Undertaker: Darke Stacy, Brinkley, Ky.
File Date: 12 February 1923
Transcribed by Debbie Tamborski, 20 February 2009 |
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