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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5302
Primary Registration District No:  
File No.  6170
Registered No:  88
2. FULL NAME:  Beard, Alfred
PERSONAL AND STATICAL PARTICULARS
3. SEX:  Male
4. COLOR OR RACE:  Black
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6. DATE OF BIRTH:  March 11, 1882
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  29 yr 1 mo 16 da
8. OCCUPATION (a.) Trade, profession or particular kind of work:  Farming
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Breckinridge Co., KY
10. NAME OF FATHER:  [Unreadable] Beard
11. BIRTHPLACE OF FATHER:  KY
12. MAIDEN NAME OF MOTHER:  Annie Robards
13. BIRTHPLACE OF MOTHER:  Ky
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Annie Beard
(Address)  Hardinsburg, KY
15. Filed  
REGISTAR:  
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  March 27, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  March 22, 1912
That I last saw him/her alive on (date):  March 26, 1912
And that death occurred on the date stated above at (time AM/PM):  3 AM
THE CAUSE OF DEATH was as follows:  Appendicitis

(Duration)   Years:            Months:            Days:  6
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A. M. Kincheloe
Date:  March 27 1912
Address:  Hardinsburg, 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:  Wales Cemetery
DATE OF BURIAL:  March 28, 1912
20. UNDERTAKER:  Robert Weatherford
ADDRESS:  Harned, KY

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Copyright.  All rights reserved.
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