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Death Volume:  1912
Certificate Number:  04476

Surname:  BROCK
Given Name:  Unnamed

Date of Death:  4 February 1912
Place of Death:  Tipton, Madison Co., KY
Race or Color:  Black
Sex:  Male 
Cause of Death:  Stillborn
Place of Burial:  Private Burying Ground
Date of Burial:  5 Feb 1912 
Date of Birth:  4 February 1912
Birth Place: 
Father's Name:  John BROCK
Father's Birth Place:  KY
Mother's Name:  Charlotte CHENAULT
Mother's Birth Place:  KY

Informant:  Robert C???? M.D.
Undertaker:  Ben F. Wilson, Waco, KY