************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ 1. PLACE OF DEATH County: BRECKINRIDGE Vot. Pol.: GLEN DEAN Inc Town: GLEN DEAN City: No. St. Ward: Registration District No.: Primary Registration District No: 5319 File No. 3596 Registered No: 2. FULL NAME: ALLEN, BIRDIE JANE LEMASTER PERSONAL AND STATICAL PARTICULARS 3. SEX: FEMALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED 6. DATE OF BIRTH: DEC 21, 1896 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 16 / 1 / 24 8. OCCUPATION (a.) Trade, profession or particular kind of work: HOUSEKEEPER (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: MEADE COUNTY 10. NAME OF FATHER: JOHN _. LEMASTER 11. BIRTHPLACE OF FATHER: KENTUCKY 12. MAIDEN NAME OF MOTHER: MARTHA JANE RIGGS 13. BIRTHPLACE OF MOTHER: HART COUNTY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) JOHN LEMASTER (Address) GLEN DEAN 15. Filed FEB 16, 1913 REGISTAR: MRS. E.L. ROBERTSON, ASSISTANT MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: FEB 15, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): JAN 15, 1913 to FEB 15, 1913 That I last saw him/her alive on (date): FEB 14, 1913 And that death occurred on the date stated above at (time AM/PM): 9 PM THE CAUSE OF DEATH was as follows: TUBERCULOSIS OF LUNGS (Duration) Years: Months: 3 Days: Contributory: PUERPERAL SEPTICEMIA (Duration) Years: Months: 1 Days: Signed (M.D.): P.E. DEMPSTER Date: FEB 16, 1913 Address: GLEN DEAN 18. LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients, or Recent Residents) At place of death (yr, mo, da.): In the State (yr, mo, da): Where was disease contracted, if not at place of death? Former or usual residence: 19. PLACE OF BURIAL OR REMOVAL: GLEN DEAN CEMETERY DATE OF BURIAL: FEB 16, 1913 20. UNDERTAKER: H. WILSON & CO ADDRESS: GLEN DEAN ADDITIONAL COMMENTS/NOTES: ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************