************************************************************************
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 Co., KY

Vot. Pol.:  No. 3

Inc Town:  Frymire, Ky

City:  

No.  10

St.  

Ward:  

Registration District No.:  

Primary Registration District No:  5310

File No.  6185

Registered No:  5310

2.       FULL NAME:  Lorma Barr

PERSONAL AND STATICAL PARTICULARS

3.       SEX:  female

4.       COLOR OR RACE:  white

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

6.       DATE OF BIRTH:  March 14, 1897

7.       AGE (yr. mo. da) (If less than 1 day, hours or min?):  14 years, 11 months, 12 days

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

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

9.       BIRTHPLACE:  Breckinridge County, KY

10.   NAME OF FATHER:  Robert L. Barr

11.   BIRTHPLACE OF FATHER:  Near Frymire, Breckinridge Co, KY

12.   MAIDEN NAME OF MOTHER:  Malisa OBryan

13.   BIRTHPLACE OF MOTHER:  near Rhodelia, Meade County, KY

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

(Informant)  Geo E. Barr

(Address)  Frymire, KY

15.   Filed  Mar 18, 1912

REGISTAR:  J.D. Cunningham per Jennie Cunningham

MEDICAL CERTIFICATE OF DEATH

16.   DATE OF DEATH:  March 12th 1912

17.   I HEREBY CERTIFY, That I attended deceased from (date):  Oct 1911 to Mar 8, 1912

That I last saw him/her alive on (date):  Mar 8, 1912

And that death occurred on the date stated above at (time AM/PM):  3 PM

THE CAUSE OF DEATH was as follows:  Tuberculosis

 

(Duration)   Years:            Months:   About 4 months         Days:  

Contributory:  

 

(Duration)   Years:            Months:            Days:  

Signed (M.D.):  J. B. Frymire

Date:  March 12, 1912

Address:  Frymire, 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:  St. Theresa

DATE OF BURIAL:  March 13, 1912

20.   UNDERTAKER:  D.S. Richardson

ADDRESS:  Union Star, KY

 




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