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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  BALLTOWN
Inc Town:  
City:  MATTINGLY
No.  
St.  
Ward:  
Registration District No.:  5321
Primary Registration District No:  21
File No.  12341
Registered No:  5
2.	FULL NAME:  BRICKEY, LILLIE MAY PERKINS
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  MARRIED
6.	DATE OF BIRTH:  NOV 22, 1890
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  23 / 7 / 3	
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  HOUSEKEEPER
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  KENTUCKY
10.	NAME OF FATHER:  JAMES PERKINS
11.	BIRTHPLACE OF FATHER:  KENTUCKY
12.	MAIDEN NAME OF MOTHER:  ALICE BEAVIN
13.	BIRTHPLACE OF MOTHER:  KENTUCKY
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  FRANK BRICKEY
(Address)  HARDINSBURG, RFD #3
15.	Filed  MAY 26, 1914
REGISTAR:  FRED FRANK
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  MAY 25, 1914
17.	I HEREBY CERTIFY, That I attended deceased from (date):  NOV 1913 to MAY 25, 1914
That I last saw him/her alive on (date):  MAY 23, 1914
And that death occurred on the date stated above at (time AM/PM):  1:50 AM
THE CAUSE OF DEATH was as follows:  PULMONARY TUBERCULOSIS
(Duration)   Years:     2       Months:            Days:    
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  JOHN E. KINCHELOE
Date:  MAY 25, 1914
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:  BRICKEY CEM
DATE OF BURIAL:  MAY 25, 1914
20.	UNDERTAKER:  M. HAMMONS & SONS
ADDRESS:  CLOVERPORT


ADDITIONAL COMMENTS/NOTES:




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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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