Death Certificate of Thas. Jeffersen Hodge 1917

Submitted by  Kathy Hines
 

  Kentucky Certificate of Death
  Registration District No. 6120
  Primary Registration District No.
  File No. 40
  Registered No. 25658
  County Laurel Co., KY
  Vot. Pct.:
  City or town: London

  Full Name: Thas. Jeffersen Hodge
  Sex: M
  Color: White
  Marital Status: Infant
  Date of Birth of deceased: Aug 22, 1917
  Age: yrs, 1 mos., 2 dys.

  Occupation: none
  Birthplace: Ky
  Name of Father: Walter Hodge
  Birthplace of Father: Ky
  Maiden Name of Mother: Carie Moore
  Birthplace of Mother: [blank]
  Informant's own signature: Mrs. Walter Hodge
  (Address) London Ky
  Filed: 10/10, 1917 OD Brock Registrar

  [right hand column of the death certificate]
  Date of Death: Sept 24, 1917
  I Hereby Certify That I attended deceased from never saw him, 19 to was found dead in bed,
  19 . I last saw h_ alive on , 19 death is said to have occurred on the date stated above, at 11
  Pm.
  Cause of Death: Dont Know - never saw him, was found dead in bed
  Due to:
  Duration:
  (Signed) Oscar D Brock, M.D.
  (Address) London Ky Date Signed: Sept 25, 1917
  Burial, cremation, or removal: Cemetery Hill Date of burial: Sept 25, 1917
  Undertaker: JB Eberlein
  (Address) London Ky