Bath County, Kentucky death certificate of Charles William Warner

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Date: Sun, 26 Jan 2003
From: <Darrell Warner> 
http://www.genrecords.net/emailregistry/vols/00001.html#0000008
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BATH COUNTY, KENTUCKY DEATH CERTIFICATE INFORMATION
1. Place of death
  a. County:Bath
  b. Voter precinct: Salt Well
  c. Inc. town: nothing listed
  d. City: Owingsville
  e. Registration district number: 51
  f. Primary registration district number: 4081
  g. File Number: 28991
  h. Registered number: 107
2. Full name: Charles William Warner
  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: Molly Warner
6. Date of birth: May 28, 1866
7. Age: 64 years 7 months 19 days
8. Occupation: none listed
9. Birthplace: Bath County, Kentucky
10. Name of father: Henry Warner
11. Birthplace of father: Bath County, Kentucky
12. Name of mother: Mandy Crockett
13. Birthplace of mother: Bath County, Kentucky
14. Informant: Molly Warner
15. Filed: December 30, 1930 Registrar: Ulary E. Gudgell
16. Date of death: December 17, 1930
17. I hereby certify, That I attended deceased from 3-25-1930 to 12-2-1930, 
that I last saw him alive on 12-2-1930, and that death occurred on the date 
stated above at (nothing listed) AM/PM.  The cause of death was as follows: 
abdominal growth, abdominal mast probable cancer.
18a. Where was disease contracted: nothing listed
18b. Signed: can't read of Mt. Sterling, Kentucky
19. Burial: Carpenter Cemetery, Bath County, Kentucky Date: December 18, 1930
20. Undertaker: E.L. Barnes of Owingsville, Kentucky