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DEATH
CERTIFICATE
Samuel Stacy
Cert: 31833
Name: Samuel Stacy
Male, White, Single
Age: 18
Occupation: Farmer
Place of Death: Ary, Perry Co., Ky
Birth Date: 1898
Place of Birth: Ky
Spouse: None
Father: Levi Stacy
Mother: Lucinda Combs
Informant: Kelsey Stacy, Ary, Ky
Death Date: 29 Dec 1916
Cause of Death: Gunshot Wounds
Signed: S. W. Richie, M. D., Dwarf, Ky
Burial Place: Ary, Ky
Undertaker: R. O. Davis, Hazard, Ky
File Date: 31 Dec 1916
Transcribed by John F. "Freddie" Wilson
17 May 2005
Levi s/o James "Blossom Jim" Stacy & Nancy Elizabeth Combs;
Lucinda d/o Kendrick Combs & Millie Combs. |
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