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DEATH
CERTIFICATE
EVERETTE ADAMS
Date 27 June 1920
Cert: # 16543
Name: Everette ADAMS
Male, White, Child
Age: 05 years, 01 months, 18 days
Place of Death: Voting Precinct #6, Knott Co., KY
Birth Date: 09 May 1915
Occupation: (blank)
Place of Birth: Knott Co., Ky.
Name of Father: Hiram ADAMS
Birthplace Father: Knott Co., Ky.
Maiden Name of Mother: Millie SMITH
Birthplace Mother: Knott Co., Ky.
Informant: Henderson SMITH, Smithsboro, Ky.
Death Date: 27 June 1920
Cause of Death: Caused by a hurt in right side,
caused
by a fall
Signed: Boggs
Burial Place: Hiram Adams
Date of Burial: 27 June 1920
Undertaker: Hiram Adams, Smithsboro, Ky.
File Date: 27 June 1920
Transcribed by Debbie Tamborski, 05 December 2008 |
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