************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ 1. PLACE OF DEATH County: BRECKINRIDGE Vot. Pol.: Inc Town: uNION sTAR City: NEAR TOWN OF UNION STAR No. St. Ward: Registration District No.: Primary Registration District No: 5309 File No. 23684 Registered No: 9 2. FULL NAME: CART, WILLIAM FRANKLIN PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: SINGLE 6. DATE OF BIRTH: MAR 20, 1842 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 71 / 6 / 0 8. OCCUPATION (a.) Trade, profession or particular kind of work: FARMER (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: NEAR UNION STAR, KY 10. NAME OF FATHER: DAVID CART 11. BIRTHPLACE OF FATHER: NEAR UNION STAR 12. MAIDEN NAME OF MOTHER: CHARLOTTE ANN WHEELER 13. BIRTHPLACE OF MOTHER: NEAR UNION STAR 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) JOHN C. CART (Address) FRYMIRE 15. Filed sEP 25, 1913 REGISTAR: LEE STEWART MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: SEP 20, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): AUG 1, 1913 to SEP 20 1913 That I last saw him/her alive on (date): And that death occurred on the date stated above at (time AM/PM): 12 AM THE CAUSE OF DEATH was as follows: CONGESTION OF BRAIN AND - - -POSTATIC CONGESTION OF LUNGS BOTH CAUSED BY POSITIONING OCCCURING TO FRACTURE ABOUT HIP JOINT (Duration) Years: Months: Days: Contributory: FRACTURE ABOUT HIP JOINT 10 JAN 1913 (Duration) Years: Months: 8 Days: 10 Signed (M.D.): - - FRYMIRE Date: SEP 21, 1913 Address: FRYMIRE 18. LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients, or Recent Residents) At place of death (yr, mo, da.): In the State (yr, mo, da): NEAR UNION STAR 7 YRS, 6 MONTHS Where was disease contracted, if not at place of death? AT PLACE OF DEATH Former or usual residence: 19. PLACE OF BURIAL OR REMOVAL: UNION STAR DATE OF BURIAL: SEP 21, 1913 20. UNDERTAKER: W.C. CART ADDRESS: UNION STAR ADDITIONAL COMMENTS/NOTES: ORIGINAL DOCUMENT IS VERY DIFFICULT TO READ - USE YELLOW FILM BACKGROUND FOR VIEWING. ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************