Martha Jane (May) Hodge
Submitted by: Kathy Hines
1915 death cert. - Martha Jane (May) Hodge
Kentucky Certificate of
Death
Registration District No. 6523
Primary Registration District No.
File No. 4694
Registered No.
County Laurel Co., KY
Vot. Pct.:
City or town: Mershans
Full Name: Martha Jane
Hodge
Sex: Female
Color: White
Marital Status: widow
Date of Birth of deceased: 11 24, 1837
Age: 77 yrs, 2 mos., 20 dys.
Occupation: Housewife
Birthplace: Laurel, Ky
Name of Father: Harrison May
Birthplace of Father: Tenn
Maiden Name of Mother: Reams
Birthplace of Mother: Tenn
Informant's own signature: Calista Hodge
(Address) Mershons, Ky
Filed: [blank] [blank] Registrar
[right hand column of the
death certificate]
Date of Death: 2-14, 1915
I Hereby Certify That I attended deceased from , 19 to ,
19 . I last saw her alive on , 19 death
is said to have occurred on the date stated above, at
__m.
Cause of Death: [blank]
Due to:
Duration:
(Signed) [blank], M.D.
(Address) [blank] Date Signed: [blank]
Burial, cremation, or removal: [blank] Date of burial:
2-15, 1915
Undertaker: [blank]
(Address) [blank]