Bath County, Kentucky death certificate of Claude Pergram

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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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BATH COUNTY, KENTUCKY DEATH CERTIFICATE
1. Place of death
  a. County: Bath
  b. Voter precinct: Olympia
  c. Incorporated town: nothing listed
  d. City: nothing listed
  e. Registration district number: 50
  f. Primary registration district number: 4089
  g. File number: 92
  h. Registered number: nothing listed
2. Full name: Claude Pergram
  a. Residence: nothing listed
3. Sex: male
4. Color or race: white
5. Single, married, widowed or divorced: married
  a. If married, widowed or divorced list husband or wife: nothing listed
6. Date of birth: November 23, 1885
7. Age: 54 years 1 month 8 days
8. Trade profession or kind of work done: nothing listed
9. Industry or business in which work was done: nothing listed
10. Date deceased last worked at this occupation: nothing listed
11. Total time spent in this occupation: nothing listed
12. Birthplace: Kentucky
13. Father's name: George Pergrem
14. Father's birthplace: Kentucky
15. Mother's maiden name: Mary Warner
16. Mother's birthplace: Kentucky
17a. Informant: Mrs. Claude Pergrem
17b. Address: Olympia
18a. Burial, cremation or removal: Griggs
18b. Date: January 3, 1939
19. Undertaker: E. L. Barnes of Owingsville, Kentucky
20a. Date filed: January 4, 1939
20b. Registrar: Mrs. Rose Bradley
21. Date of death: January 2, 1939
22. I hereby certify, that I attended deceased from December 28, 1938 to 
January 2, 1939.  I last saw him alive on January 1, 1939, death is said 
to have occurred on the date stated above at 10:00 AM.  The principal 
cause of death and related causes of importance in order of onset were 
as follows: Hypertensive heart disease.  Contributory causes of importance 
not related to principal cause: arteriosclerosis.
23. If death was due to external causes (violence) fill in also the 
following: nothing listed.
24a. Was disease or injury in any way related to occupation of deceased: 
nothing listed
24b. Signed: D. C. Dotson MD of Owingsville, Kentucky