Kentucky Certificate of Death
Registration District No. 6515
Primary Registration District No.
File No. 15523
Registered No. 12
County Laurel Co., KY
Vot. Pct.: Lily
City or town: Corbin
Full Name: Rosanna Hodge
Marital Status: widowed
Date of Birth of deceased: 6 23, 1851
Age: 70 yrs, - mos., 14 dys.
Occupation: at home
Birthplace: Knox Co., Ky
Name of Father: Moses Hubbard
Birthplace of Father: Ky [written over the word] Unknown
Maiden Name of Mother: --- Jackson
Birthplace of Mother: Ky [written over the word] Unknown
Informant's own signature: Jesse E. Scalf
Filed: July 8, 1921 J.G. Owsley Registrar
[right hand column of the death certificate]
Date of Death: July 7, 1921
I Hereby Certify That I attended deceased from June 15, 1921 to July 7th, 1921. I last saw her
alive on June 15th, 1921 death is said to have occurred on the date stated above, at 1:30 Pm.
Cause of Death: Chronic Diarrhea, Auce, Disease of Stomache
Due to: Old age
Duration: 1 yrs. 1 mos.
(Signed) Jy[?] t. Parker, M.D.
(Address) Corbin Date Signed: July 7, 1921
Burial, cremation, or removal: McHargue Cemetery Date of burial: 7-8, 1921
Undertaker: WC Skaggs
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