************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************ 1. PLACE OF DEATH County: Breckinridge Vot. Pol.: 12 Inc Town: Irvington City: Irvington No. St. Ward: Registration District No.: Primary Registration District No: 5312 File No. 16551 Registered No: 2. FULL NAME: George Bandy PERSONAL AND STATICAL PARTICULARS 3. SEX: male 4. COLOR OR RACE: white 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: married 6. DATE OF BIRTH: October 20, 1869 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 42 years, 9 months, 24 days 8. OCCUPATION (a.) Trade, profession or particular kind of work: farmer (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: Kentucky 10. NAME OF FATHER: R.S. Bandy 11. BIRTHPLACE OF FATHER: Kentucky 12. MAIDEN NAME OF MOTHER: Mary McCoy 13. BIRTHPLACE OF MOTHER: Kentucky 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) W.G. Bandy (Address) Irvington, KY 15. Filed July 31, 1912 REGISTAR: D.W. Henry MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: July 14, 1912 17. I HEREBY CERTIFY, That I attended deceased from (date): July 14, 1912 That I last saw him/her alive on (date): July 14, 1912 And that death occurred on the date stated above at (time AM/PM): 6 a.m. THE CAUSE OF DEATH was as follows: appendicitis (Duration) Years: Months: Days: 4 Contributory: (Duration) Years: Months: Days: Signed (M.D.): S.P. Parks, M.D. Date: July 14, 1912 Address: Irvington, 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: Irvington, KY DATE OF BURIAL: July 15, 1912 20. UNDERTAKER: G. T. Marshall & Son ADDRESS: Irvington, KY ************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************