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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  WEBSTER
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.: 5311  
Primary Registration District No:  
File No.  9522
Registered No:  
2.	FULL NAME: CAROLINE H. AVIT  
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE: WHITE  
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED 
6.	DATE OF BIRTH:  DEC 26, 1853
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?): 59YRS 3MOS 8DS  
8.	OCCUPATION (a.) Trade, profession or particular kind of work:HOUSEWIFE  
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  BRECKINRIDGE CO, KY
10.	NAME OF FATHER:  WASHINGTON WEST
11.	BIRTHPLACE OF FATHER:  BRECK CO, KY
12.	MAIDEN NAME OF MOTHER:  ELIZABETH TABOR
13.	BIRTHPLACE OF MOTHER:  BRECKINRIDGE CO
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  MEADOR SIMMONS
(Address)  LODIBURG, KY
15.	Filed  4/19/1913
REGISTAR:  HOLLIS DRANE
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  APRIL 18, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date): APR 6, 1913 TO APR 18, 1913 
That I last saw him/her alive on (date): APR 18, 1913 
And that death occurred on the date stated above at (time AM/PM):  
THE CAUSE OF DEATH was as follows:  
ORGANIC HEART TROUBLE FOLLOWING LA GRIPPE
(Duration)   Years:            Months: 4         Days: 2 
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  T.J. HENDRICK
Date:  APR 19, 1913
Address:  WEBSTER, KY
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: WALNUT GROVE  
DATE OF BURIAL:  APR 19, 1913
20.	UNDERTAKER:  G.T. MARSHALL
ADDRESS:  IRVINGTON, KY


ADDITIONAL COMMENTS/NOTES:
From Breck Co Cemeteries Vol 1, Caroline was married to Lewis Green Avitt.



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