Montgomery County, Kentucky death certificate of Robert Edward Henderson

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Date: Sun, 26 Jan 2003
Darrell Warner
From: http://www.genrecords.net/emailregistry/vols/00001.html#0000008
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MONTGOMERY COUNTY, KENTUCKY DEATH CERTIFICATE
1.  Place of death
  a. County: Montgomery
  b. Voter precinct: Grassylick
  c. Inc. Town: nothing listed
  d. City: Mt. Sterling
  e. Registration district number: 6756
  f. Primary registration district number: nothing listed
  g. File number: 25769
  h. Registered number: nothing listed
2. Full name: Robert Edward Henderson
3. Sex: male
4. Color or race: white
5. Single, married, widowed or divorced: single
6. Date of birth: September 19, 1930
7. Age 3 days
8. Occupation: infant
9. Birthplace: Kentucky
10. Name of father: Roy Henderson
11. Birthplace of father: Kentucky
12. Maiden name of mother: Gertie Perkins
13. Birthplace of mother: Kentucky
14. Informant: Roy Henderson of Mt. Sterling, Kentucky
15. Filed: November    Registrar: Mrs. J. S. Mason
16. Date of death: September 23, 1930
17a. I hereby certify, That I attended deceased from September 19, 
1930 to September 23, 1930, that I last saw him alive on September 23, 
1930, and that death occurred on the date stated above at 4:00 AM.  The 
cause of death was as follows: premature birth
17b. Signed: Morton Faulkner MD of Mt. Sterling, Kentucky September 23, 1930
18. Length of residence: nothing listed
19a. Place of burial: Crown Hill Cemetery
19b.Date of burial: September 23, 1930
20. Undertaker: A. L. Mitchell Jr. of Mt. Sterling, Kentucky