************************************************************************
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.:  Webster
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5311
Primary Registration District No:  
File No.  97046
Registered No:  
2. FULL NAME:  Combs, Benedick
PERSONAL AND STATICAL PARTICULARS
3. SEX:  Male
4. COLOR OR RACE:  White
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6. DATE OF BIRTH:  Aug. 19, 1842
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  70 yr 2 mo 24 da
8. OCCUPATION (a.) Trade, profession or particular kind of work:  Farmer
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  KY
10. NAME OF FATHER:  Joseph Combs
11. BIRTHPLACE OF FATHER:  Nelson Co., KY
12. MAIDEN NAME OF MOTHER:  Delia Roby
13. BIRTHPLACE OF MOTHER:  Nelson Co., KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Henry Cashman
(Address)  Raymond, KY
15. Filed  Nov. 14, 1912
REGISTRAR:  H. P. Newman
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Nov. 13, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  May 10, 1912
That I last saw him/her alive on (date):  Nov. 11, 1912
And that death occurred on the date stated above at (time AM/PM):  6:30 PM
THE CAUSE OF DEATH was as follows:  Paralysis agitans

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

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  T. J. Hendrick
Date:  Nov. 14, 1912
Address:  Webster, 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:  Raymond
DATE OF BURIAL:  Nov. 14, 1912
20. UNDERTAKER:  G. T. Marshall
ADDRESS:  Irvington, KY


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