************************************************************************
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.:  BALLTOWN

Inc Town:  

City:  

No.  5321

St.  

Ward:  

Registration District No.:  

Primary Registration District No:  

File No.  20140

Registered No:  8

2. FULL NAME:  BEAVIN, WILLIAM P.

PERSONAL AND STATICAL PARTICULARS

3. SEX:  MALE

4. COLOR OR RACE:  WHITE

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

6. DATE OF BIRTH:  FEB 13, 1844

7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  67 / 6 / 7

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

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

9. BIRTHPLACE:  KENTUCKY

10. NAME OF FATHER:  JOHN HOWARD BEAVIN

11. BIRTHPLACE OF FATHER:  KENTUCKY

12. MAIDEN NAME OF MOTHER:  MELIA GREGORY

13. BIRTHPLACE OF MOTHER:  KENTUCKY

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

(Informant)  G.W. BEAVIN

(Address)  

15. Filed  AGU 22, 1911

REGISTAR:  FRED FRANK

MEDICAL CERTIFICATE OF DEATH

16. DATE OF DEATH:  AUG 20, 1911

17. I HEREBY CERTIFY, That I attended deceased from (date):  JUN 1, 1911 to AUG 20, 1911

That I last saw him/her alive on (date):  AUG 18, 1911

And that death occurred on the date stated above at (time AM/PM):  1 AM

THE CAUSE OF DEATH was as follows:  VASCULAR DISEASE OF HEART

 

(Duration)   Years:            Months:            Days:  

Contributory:  

 

(Duration)   Years:            Months:            Days:  

Signed (M.D.):  WM. HOWARD

Date:  MATTINGLY, KY

Address:  

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:  PI - - - -  BURYING GROUND

DATE OF BURIAL:  AUG 21, 1911

20. UNDERTAKER:  M. HAMMAN & SONS

ADDRESS:  CLOVERPORT

 

TRANSCRIBER’S NOTE:  ORIGINAL BURIAL LOCATION TAUL BURYING GROUND ETCHED OUT & RE-WRITTEN

SECONDARY TRANSCRIBER'S NOTE:  REWRITTEN BURIAL LOCATION IS PISGAH BAPTIST CHURCH
  
  

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