Thas. Jeffersen Hodge
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