************************************************************************ 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.: Hardinsburg Inc Town: City: No. St. Ward: 2 Registration District No.: 130 Primary Registration District No: 5302 File No. 3314 Registered No: 18 or 78 ?? 2. FULL NAME: Board/Beard ??, Edward W. PERSONAL AND STATICAL PARTICULARS 3. SEX: male 4. COLOR OR RACE: black 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: married 6. DATE OF BIRTH: Sept. 9, 1873 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 38 yrs. 5 mos. 13 ds. 8. OCCUPATION (a.) Trade, profession or particular kind of work: School Teacher (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: Kentucky 10. NAME OF FATHER: Solomon Board or Beard?? I think looks like Beard rather than Board 11. BIRTHPLACE OF FATHER: Kentucky 12. MAIDEN NAME OF MOTHER: Laney Dean ????? 13. BIRTHPLACE OF MOTHER: Kentucky 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Ernest Board or Beard?? (Address) Hardinsburgg, KY 15. Filed Feb 24, 1912 REGISTAR: W. B. Lennon MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: Feb. 23, 1912 17. I HEREBY CERTIFY, That I attended deceased from (date): Jan. 18, 1912 to Feb 23, 1912 That I last saw him/her alive on (date): Fwb. 18, 1912 And that death occurred on the date stated above at (time AM/PM): 4:40 a.m. THE CAUSE OF DEATH was as follows: chronic nephritis (Duration) Years: Months: 1 Days: 6 Contributory: (Duration) Years: Months: Days: Signed (M.D.): Jno. E. Kincheloe Date: Feb 24, 1912 Address: Hardinsburg 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: Hardinsburg Cemetery DATE OF BURIAL: Feb. 24, 1912 20. UNDERTAKER: Jno. T. Hober ADDRESS: Hardinsburg ************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************