DEATH CERTIFICATE

POLLY STACY

Name: Polly Stacy
Female, White, Married
Age: 73
Occupation: Invalid
Place of Death: Mining Camp, Perry Co.
Birth Date: 24 Dec 1867
Place of Birth: Perry Co., Ky
Spouse: Shade Stacy
Father: Wesley Fields
Mother: Lina Young
Informant: E. H. Stacy, Blue Diamond, Ky
Death Date: 14 July 1941
Cause of Death: Can't read
Signed: ?? Bryant, M.D.
Burial Place: Family
Undertaker: D. F. Burke, Hazard, Ky
File Date: 1 Sept 1941
Transcribed by John F. "Freddie" Wilson