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DEATH
CERTIFICATE
SCOTT SUMNER
Date 19 May 1912
Cert: # 16711
Name: Scott SUMNER
Male, White, Single
Age: 01 years, 12 days
Place of Death: Voting Precinct Carrs Fork, Perry Co., KY
Birth Date: 25 April 1911
Occupation: None
Place of Birth: Perry Co., Ky.
Name of Father: William D. SUMNER
Birthplace Father: Perry Co., Ky.
Maiden Name of Mother: Martha ROARK SUMNER
Birthplace Mother: Knott Co., Ky.
Informant: (blank)
Death Date: 19 May 1912
Cause of Death: acute dysentery
Signed: F. C. Roark, M.D.
Burial Place: (blank)
Date of Burial: (blank)
Undertaker: (blank)
File Date: (blank)
Transcribed by Debbie Tamborski, 03 December 2008 |
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