************************************************************************
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:   
Registration District No.:  130
Primary Registration District No:  5302
File No.  226151
Registered No:   
2. FULL NAME:  EVYLIN B. BUTLER
PERSONAL AND STATICAL PARTICULARS
3. SEX:  FEMALE
4. COLOR OR RACE:  WHITE
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  SINGLE
6. DATE OF BIRTH:  OCT 19 1913
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):    YR  MO   DA   3 MIN
8. OCCUPATION (a.) Trade, profession or particular kind of work:  NOTHING
(b.)  General nature of industry business or establishment which employed:   
9. BIRTHPLACE:  KY
10. NAME OF FATHER:  MARCELLUS H BUTLER
11. BIRTHPLACE OF FATHER:  KY
12. MAIDEN NAME OF MOTHER:  DELLA ALLEN
13. BIRTHPLACE OF MOTHER:  KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  C B BUTLER
(Address)  HARNED KY
15. Filed  OCT 20,  1913
REGISTAR:  W B LENNON
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  OCT 19,   1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  OCT 19, 1913 TO OCT 19, 1913
That I last saw him/her alive on (date):  HIM OCT 19,  1913
And that death occurred on the date stated above at (time AM/PM):  1:38 A 
THE CAUSE OF DEATH was as follows:  PREMATURE BIRTH PERIOD OF GESTATION ABOUT 6 MO-18 DAYS
 
(Duration)   Years:            Months:            Days:  
Contributory:   SENILITY
 
(Duration)   Years:            Months:            Days:   
Signed (M.D.):  J E MATTHEWS
Date:   OCT 19, 1913
Address:  WESTVIEW, 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:  SCOTT CEMETERY
DATE OF BURIAL:  OCT 20, 1913
20. UNDERTAKER:  B F BEARD C CO
ADDRESS:  HARDINSBURG KY
 

ADDITIONAL COMMENTS/NOTES:



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