************************************************************************
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.: Big Spring

Inc Town: Whard Big Spring KY

City:

No.

St.

Ward

Registration District No.: 5314

Primary Registration District No: 14

File No. 16554

Registered No: 6

2.       FULL NAME: Morris Witt Brownrigg

PERSONAL AND STATICAL PARTICULARS

3.       SEX: Male    

4.       COLOR OR RACE: White

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

6.       DATE OF BIRTH: Feb 11, 1912

7.       AGE  (yr. mo. da) (If less than 1 day, hours or min?): 5 mo, 18 da

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

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

9.       BIRTHPLACE: Mead Co KY

10.   NAME OF FATHER: Class Brownrigg

11.   BIRTHPLACE OF FATHER: Mainstree MI

12.   MAIDEN NAME OF MOTHER: Elsir Tate

13.   BIRTHPLACE OF MOTHER: KY

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

(Informant) Class Brownrigg

(Address) Big Spring KY

15.   Filed Jul 30, 1912

REGISTAR: J.L. Morris

MEDICAL CERTIFICATE OF DEATH

16.   DATE OF DEATH: July 29, 1912

17.   I HEREBY CERTIFY, That I attended deceased from (date): July 20, 1912 to July 29, 1912

That I last saw him/her alive on (date): July 29, 1912

And that death occurred on the date stated above at (time AM/PM): 12 PM

THE CAUSE OF DEATH was as follows: Cholera Infantum

 

(Duration)

Years:

Months:

Days: 9

Signed (M.D.): C.B. Witt

Date: July 29, 1912

Address: Big Spring, 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 Baptist Church Cem

DATE OF BURIAL: July 30, 1912

20.   UNDERTAKER: J.A. Haynes

ADDRESS: Big Spring




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