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DEATH
CERTIFICATE
AGGIE J. TRIPLETT
Date 09 August 1915
Cert: 19307
Place of Death: Voting Precinct: Melvin, Floyd Co., Ky.
Full Name: Aggie J. TRIPLETT
Sex, Color or Race, Marital Status: Female, White,
(blank)
Date of Birth: 23 November 1909
Age: 05 years, 08 months, 16 days
Occupation: Infant
Birthplace: Knott Co., Ky.
Name of Father: Allen TRIPLETT
Birthplace Father: Floyd Co., Ky.
Maiden name of Mother: Florence CAUDILLE
Birthplace Mother: Floyd Co., Ky.
Informant/Address: E. F. King, M.D., Weeksbury, Ky.
Filed: 10 August 1915
Registrar: Hiram Hall
Death Date: 09 August 1915
I hereby certify that I attended deceased from 02 August 1915, to
09 August 1915, that I last saw her alive on 09 August 1915, and that death
occurred, on the date stated above, at 6 p.m.
Cause of Death: Membrainos croup
Duration: 07 days
Contributory: (blank)
Signed/Address: E. F. King, M.D., 10
August 1915, Weeksburg, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: W. R. Hall G. yd.
Date of Burial: 10 August 1915
Undertaker/Address: (illegible) Caudille, Melvin, Ky.
Transcribed by Debbie Tamborski, 26 February 2010 |
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