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DEATH
CERTIFICATE
EVALINE WIREMAN
Date 27 April 1915
Cert: 10688
Place of Death: Voting Precinct: Atkison, Magoffin Co.,
Ky.
Full Name: Evaline WIREMAN
Sex, Color or Race, Marital Status: Female, White,
Married
Date of Birth: 27 April 1887
Age: 28 years
Occupation: Housewife
Birthplace: Knott County
Name of Father: Dave CONLY
Birthplace Father: Knott Co.
Maiden name of Mother: Caroline VANDERPOOL
Birthplace Mother: Magoffin Co., Ky.
Informant/Address: Noah WIREMAN, Wireman, Ky.
Filed: 29 April 1915
Registrar: W. P. Power
Death Date: 27 April 1915
I hereby certify that I attended deceased from (blank), to
(blank), that I last saw h-- alive on (blank), and that death
occurred, on the date stated above, at (blank)
Cause of Death: Pneumonia fever
Duration: (blank)
Contributory: (blank)
Signed/Address: (blank)
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Jack Wireman Cemetery
Date of Burial: 29 April 1915
Undertaker/Address: Noah Wireman, Wireman, Ky.
Transcribed by Debbie Tamborski, 26 February 2010 |
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