Death Certificate of Rowland Hodge 1919

Submitted by  Kathy Hines
 

  Kentucky Certificate of Death - marked "DELAY"
  Registration District No. 6515
  Primary Registration District No. 6515
  File No. 28098
  Registered No. 3
  County Laurel Co., KY
  Vot. Pct.: Lily
  City or town:

  Full Name: Rowland Hodge
  Sex: M
  Color: White
  Marital Status: Single
  Date of Birth of deceased: May 25, 1918
  Age: yrs, 10 mos., 28 dys.

  Occupation: none
  Birthplace: Ky
  Name of Father: S.W. Hodge
  Birthplace of Father: Ky
  Maiden Name of Mother: Mossie Broyls
  Birthplace of Mother: Tenn
  Informant's own signature: Mossie Hodge
  (Address) Lily Ky
  Filed: Apr 24, 1919 J.G. Owsley Registrar

  [right hand column of the death certificate]
  Date of Death: April 23, 1919
  I Hereby Certify That I attended deceased from April 20, 1919 to April 23, 1919. I last saw him
  alive on April 22, 1919, and that death occurred on the date stated above, at 7 Am.
  Cause of Death: Lobar Pneumonia
  Due to:
  Duration: 4 ds.
  (Signed) J. G. Owsley, M.D.
  (Address) Lily Ky Date Signed: April 24, 1919
  Burial, cremation, or removal: Lily Date of burial: Apr 24, 1919
  Undertaker: C.B. Gilbert
  (Address) Lily Ky