DEATH CERTIFICATE
(stillbirth) ADAMS

Date   04 July 1915
Deathvol Vol:   1915
Cert: #  17577
Name:  (stillbirth) ADAMS
Male, Black
Age:  stillbirth
Place of Death: Voting Pct. No. 6, Knott Co., KY
Birth Date:  04 July 1915                          
Place of Birth:  Knott Co.
Father:  Noah ADAMS                                                   Birthplace Father:  Letcher Co., Ky.
Mother:  Tilda ADAMS                                                       Birthplace Mother:  Knott Co.
Informant:  Noah ADAMS, Sassafras, Ky.
Death Date:  04 July 1915
Cause of Death:  Cause not know (?) than the last to have been dead--Stillbirth
Signed:  Elsie Kelley, Midwife
Burial Place:  James Stacys
Undertaker:  Noah Adams, Sassafras, Ky.
File Date: 04 July 1915
Transcribed by Debbie Tamborski, 31 July 2008