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1.	PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Webster
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5311
Primary Registration District No:  
File No.  31418
Registered No:  
2.	FULL NAME:  Dara A. Bruce
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  Female
4.	COLOR OR RACE:  White
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6.	DATE OF BIRTH:  Feby 11, 1846
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  67 yrs, 9 mos, 7 ds
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  Housewife
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  Madison Co Ky
10.	NAME OF FATHER:  Nathan Bonnie
11.	BIRTHPLACE OF FATHER:  
12.	MAIDEN NAME OF MOTHER:  
13.	BIRTHPLACE OF MOTHER:  Clark Co Ky
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Charlie Bruce
(Address)  Lodiburg
15.	Filed  12/19, 1913
REGISTAR:  H. Drane
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  Dec 18, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  Dec 6, 1913 to Dec 18, 1913
That I last saw her alive on (date):  Dec 18, 1913
And that death occurred on the date stated above at (time AM/PM):  12 AM
THE CAUSE OF DEATH was as follows:  Cirrhosis of the liver

(Duration)   Years:            Months:            Days:  12
Contributory:  
Heart
(Duration)   Years:            Months:            Days:  2
Signed (M.D.):  Wm L Milner
Date:  12/18, 1913
Address:  Union Star
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:  Walnut Grove
DATE OF BURIAL:  12/20, 1913
20.	UNDERTAKER:  G. T. MARSHALL
ADDRESS:  Irvington


ADDITIONAL COMMENTS/NOTES:


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File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net

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