************************************************************************
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: 

No.

St.

Ward

Registration District No.:

Primary Registration District No: 5310

File No. 5312

Registered No: 11

2.       FULL NAME:  Taylor Bandy

PERSONAL AND STATICAL PARTICULARS

3.       SEX: male

4.       COLOR OR RACE: white

5.       SINGLE, MARRIED, WIDOWED, OR DIVORCED: married

6.       DATE OF BIRTH: Dec 24, 1858

7.       AGE  (yr. mo. da) (If less than 1 day, hours or min?): 53 years, 8 mo, 14 days

8.       OCCUPATION (a.) Trade, profession or particular kind of work: farmer

(b.)  General nature of industry business or establishment which employed:

9.       BIRTHPLACE: Breckinridge

10.   NAME OF FATHER: Richard Bandy

11.   BIRTHPLACE OF FATHER: Breckinridge

12.   MAIDEN NAME OF MOTHER: Betsy Claycomb 

13.   BIRTHPLACE OF MOTHER: Breckinridge

14.   THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE

(Informant) B. Gibson

(Address) Irvington, KY

15.   Filed Sept 10, 1911

REGISTAR: D. W. Henry

MEDICAL CERTIFICATE OF DEATH

16.   DATE OF DEATH: Sept 9, 1911

17.   I HEREBY CERTIFY, That I attended deceased from (date):Sept 7, 1911 to Sept 9, 1911

That I last saw him/her alive on (date): Sept 7, 1911

And that death occurred on the date stated above at (time AM/PM): 2 am

THE CAUSE OF DEATH was as follows: Appendicitis chronic with su----- & general infection

 
(Duration) 

Years: 5 years

Months:

Days:

Signed (M.D.): L. B. Moorman

Date: 9/20, 1911

Address: Irvington

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: Sept 10, 1911

20.   UNDERTAKER: G. T. Marshall

ADDRESS: Irvington, KY


************************************************************************
Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
************************************************