DEATH CERTIFICATE
SUSIE GRIGSBY

Date    05 September 1911
Death Vol:   1911
Cert: #  24261
Name:  Susie GRIGSBY
Female, White, Single
Age:  4 years
Place of Death: Voting Pct. No. 8, Perry Co., KY
Birth Date:  September 1907
Place of Birth:  Ky.
Father:  Sam GRIGSBY                                                     Birthplace Father: Ky.
Mother:  Sally EVERSOLE                                                      Birthplace Mother:  Ky.
Informant:  Not Listed
Death Date:  05 September 1911
Cause of Death:  Membranous Croup
Signed:  G. C. Morgan, M.D.
Burial Place:  Not Listed
Undertaker:  Not Listed
File Date: 07 September 1911
Transcribed by Debbie Tamborski, 24 June 2008