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1.	PLACE OF DEATH
County: BRECKINRIDGE 
Vot. Pol.: HARDINSBURG 
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.: 130  
Primary Registration District No: 5301  
File No. 31404 
Registered No:  
2.	FULL NAME: WILLIAM LEWIS BALL  
PERSONAL AND STATICAL PARTICULARS
3.	SEX: MALE 
4.	COLOR OR RACE: WHITE  
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED (CIRCLED) & WIDOWED  
6.	DATE OF BIRTH: DEC 20, 1840 
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?): 73YRS 11DS 
8.	OCCUPATION (a.) Trade, profession or particular kind of work: COOPER 
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE: KY- BRECKINRIDGE CO 
10.	NAME OF FATHER: JOHN W. BALL 
11.	BIRTHPLACE OF FATHER: VIRGINIA 
12.	MAIDEN NAME OF MOTHER: MARY CLARK  
13.	BIRTHPLACE OF MOTHER: KY- BRECKINRIDGE CO 
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) G.A. WRIGHT 
(Address) MCQUADY, KY 
15.	Filed JAN 1, 1914 
REGISTAR: W.B. LENNON 
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH: DEC 31, 1913  
17.	I HEREBY CERTIFY, That I attended deceased from (date): 12-28-1913 TO   12-31-1913
That I last saw him/her alive on (date): 12-31-1913  
And that death occurred on the date stated above at (time AM/PM): 8:30 AM  
THE CAUSE OF DEATH was as follows:  
MYOCARDITIS CHRONIC
(Duration)   Years:            Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A.L. KINCHELOE
Date: JAN 1, 1914 
Address: MCQUADY 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: MCQUADY KY 
DATE OF BURIAL: JAN 1, 1914 
20.	UNDERTAKER: E.F. LYONS 
ADDRESS: MCQUADY, KY 


ADDITIONAL COMMENTS/NOTES:
From Breck Co Cemeteries Book Vol 1, William is buried with wife, Henrietta at Corinth Baptist Cemetery.



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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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