Montgomery County, Kentucky death certificate of George R. Warner

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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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KENTUCKY DEATH RECORD
Registration district number: 1070
Primary registration district number: 2425
State file number: 14165
Registrar number: 83
1. Place of death
  a. County: Montgomery
  c. City or town: Mt. Sterling, Kentucky
  d. If not in hospital or institution write street number or location: nothing listed
2. Usual residence of deceased
  a. State: Kentucky
  b. County: Montgomery
  c. City or town: Mt. Sterling, Kentucky
  d. Street number: nothing listed
  e. If foreign born how long in USA: nothing listed
3a. Full name: George Warner
3b. If veteran name war: nothing listed
3c. Social security number: nothing listed
4. Sex: male
5. Color or race: white
6. Single, married, widowed or divorced: single
6b. Name of husband or wife if alive: nothing listed
6c. Age of husband or wife if alive: nothing listed
7. Birth date of deceased: February 6, 1871
8. Age: 76
9. Birthplace: Bath County, Kentucky
10. Usual occupation: retired carpenter
11. Name of industry or business: nothing listed
12. Name of father: Stephen M. Warner
13. Birthplace of father: Kentucky
14. Name of mother: Catherine Clark
15. Birthplace of mother: Kentucky
16. Informant: Kelly Thompson of Mt. Sterling, Kentucky
17. Burial, cremation or removal: burial
  a. Place: Machpelah Cemetery
  b. Date: June 29, 1947
18. Signature of funeral director: Mitchel Funeral Home
19a. Date received by local registrar: June 30, 1947
19b. Name of registrar: Elizabeth Myate
20. Date of death: June 28, 1947
21. I hereby certify that I attended the deceased from (nothing listed to 
(nothing listed, that I last saw him alive on (nothing listed, and that 
death occurred on the date stated above at 8:00 AM.  Immediate cause of 
death: gunshot wound
22. If death was due to external causes, fill in the following
  a. Accident, suicide or homicide: suicide
  b. Date of occurrence: June 28, 1947
  c. Where did injury occur: public place
  d. While at work: no
  e. Means of injury: gunshot
23. Signature: Tom Douglas, Coroner
  a. Address: Mt. Sterling
  b. Date signed: June 28, 1947