Death Records: Adair County KY  Wilmer BROCKMAN     05-Apr-1886 to 20-Oct-1918

Submitted By: Lou Keller LouLouBelleKell@aol.com
Submission Date: 20-Aug-2005
Source: Photocopy of Death Certificate

Surname: BROCKMAN
Given Name(s): Wilmer

File#: (illegible)
Registered#: 11
Registration District#: 5009
Primary Registration District#: 9
Vote Precinct: White Oak

Sex: Male
Race: White
Marital Status: Single
Birth Date: 05-Apr-1886
Birth Place: Russell County, KY
Death Date: 20-Oct-1918, 4 P.M.
Age at Death: 32 years, 6 months, 15 days

Occupation: Farmer

Father’s Name: M. W. BROCKMAN
Father’s Birth Place: KY
Mother’s Maiden Name: N.J. BLAIR
Mother’s Birth Place: KY
Informant: Lucian BROCKMAN
Informant’s Address: Ozark, KY

Physician: W. L. CARTWRIGHT, M.D.
Physician’s Address: Columbia, KY
Attended from: 16-Oct-1918  to: 20-Oct-1918   last seen alive: 20-Oct-1918
Date Signed: 20-Oct-1918
Date Filed: 26-Oct-1918, A.J. COMBEST
Cause of Death: Pneumonia
Contributory Cause(s): Influenza (10 days)

Date of Burial: 21-Oct-1918
Place of Burial: Bryant..... 
Undertaker: J. B. JONES
Address: Columbia, KY

SURNAMES: BLAIR, BROCKMAN, CARTWRIGHT, COMBEST, JONES

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