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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  BIG SPRING
Inc Town:  BIG SPRING
City:  
No.  
St.  
Ward:  
Registration District No.:  5314
Primary Registration District No:14 
File No.  28700
Registered No: 17 
2.	FULL NAME:  CARMAN, LUCY E. ADKISSON
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  MARREID
6.	DATE OF BIRTH:  JAN 3, 1871
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  42 / 10 / 13
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  HOUSEWIFE
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  BRECKINRIDGE
10.	NAME OF FATHER:  JOHN ADKISSON
11.	BIRTHPLACE OF FATHER:  MADISON COUNTY
12.	MAIDEN NAME OF MOTHER:  ELIZA TRENT
13.	BIRTHPLACE OF MOTHER:  BRECKINRIDGE
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  J.A. RITCHIE
(Address)  BIG SPRING
15.	Filed  NOV 17, 1913
REGISTAR:  J.L. MORRIS
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  NOV 16, 1917
17.	I HEREBY CERTIFY, That I attended deceased from (date):  OCT 1, 1913 to NOV 16, 1913
That I last saw him/her alive on (date):  NOV 13, 1913
And that death occurred on the date stated above at (time AM/PM):  8 AM
THE CAUSE OF DEATH was as follows:  ACUTE PULMONARY TUBERCULOSIS
(Duration)   Years:            Months:     1       Days:    16
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  C.B. WITT
Date:  NOV 16, 1913
Address:  BIG SPRING
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:  ADKISSON CEMETERY
DATE OF BURIAL:  NOV 17, 1913
20.	UNDERTAKER:  ALF TAYLOR
ADDRESS:  CUSTER, KY


ADDITIONAL COMMENTS/NOTES:




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