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DEATH
CERTIFICATE
MARY ADAMS
Date 13 June 1921
Cert: # 12939
Name: Mary ADAMS
Female, White
Age: 02 months, 11 days
Place of Death: Voting Precinct #14, Knott Co., KY
Birth Date: 02 April 1921
Occupation: Infant
Place of Birth: Knott Co.
Name of Father: Bob ADAMS
Birthplace Father: Knott Co.
Maiden Name of Mother: Susie KING
Birthplace Mother: Knott Co.
Informant: Harim HALL, Puncheon, Ky.
Death Date: 13 June 1921
Cause of Death: Summer complaint
Signed: (blank)
Burial Place: B.F. Strange
Date of Burial: 14 June 1921
Undertaker: Harim Hall, Puncheon, Ky.
File Date: 05 July 1921
Transcribed by Debbie Tamborski, 05 December 2008 |
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