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1. PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  Union Star
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5309
Primary Registration District No:  
File No.  22922
Registered No:  8
2. FULL NAME:  CASHMERE, JAMES L.
PERSONAL AND STATICAL PARTICULARS
3. SEX:  MALE
4. COLOR OR RACE:  WHITE
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  WIDOWED
6. DATE OF BIRTH:  MAR. 5, 1835
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  79 YR 6 MO
8. OCCUPATION (a.) Trade, profession or particular kind of work:  FARMER
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  BRECKINRIDGE CO., KY
10. NAME OF FATHER:  JAMES CASHMERE
11. BIRTHPLACE OF FATHER:  BRECKINRIDGE CO., KY
12. MAIDEN NAME OF MOTHER:  ELIZABETH CORT
13. BIRTHPLACE OF MOTHER:  BRECKINRIDGE CO., KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  C. W. CORT
(Address)  MYSTIC, KY
15. Filed  SEPT. 6, 1914
REGISTRAR:  LEE STEWART
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  SEPT. 5, 1914
17. I HEREBY CERTIFY, That I attended deceased from (date):  AUGUST 1914
That I last saw him/her alive on (date):  AUG. 19, 1914
And that death occurred on the date stated above at (time AM/PM):  
THE CAUSE OF DEATH was as follows:  ARTERIOSCLEROSIS

(Duration)   Years:            Months:    2       Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.): WM. MILNER    
Date:  SEPT. 7, 1914
Address:  UNION STAR, 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:  UNION STAR, KY
DATE OF BURIAL:  SEPT. 6, 1914
20. UNDERTAKER:  D. S. RICHARDSON
ADDRESS:  UNION STAR, KY