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1.	PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  5306
Inc Town:  
City:  
No.  
St.  
Ward:  2
Registration District No.:  131
Primary Registration District No:  2065
File No.  17459
Registered No:  156
2.	FULL NAME:  Ben Davenport
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  Male
4.	COLOR OR RACE:  Colored
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6.	DATE OF BIRTH:  Don’t Know, 1880
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  34 yrs
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  Laborer
(b.)  General nature of industry business or establishment which employed:  General work
9.	BIRTHPLACE:  Kentucky
10.	NAME OF FATHER:  Russel Davenport
11.	BIRTHPLACE OF FATHER:  Kentucky
12.	MAIDEN NAME OF MOTHER:  Mary Jane Braxton
13.	BIRTHPLACE OF MOTHER:  Kentucky
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Minnie Davenport
(Address)  Cloverport, Ky
15.	Filed  July 1st, 1914
REGISTAR:  J. C. Nolte
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  July 1 st, 1914
17.	I HEREBY CERTIFY, That I attended deceased from (date):  June 14, 1914 to July 1st, 1914
That I last saw him/her alive on (date):  July 1st, 1914
And that death occurred on the date stated above at (time AM/PM):  12;35 p.m.
THE CAUSE OF DEATH was as follows:  Phthisis Pulmonalis

(Duration)   Years:            Months:  6          Days:  
Contributory:  Exposure and heredity

(Duration)   Years:  1          Months:            Days:  
Signed (M.D.):  D. R. Lightfoot, M.D.
Date:  July 1st, 1914
Address:  Cloverport, 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:  Cloverport, Ky
DATE OF BURIAL:  July 2, 1914
20.	UNDERTAKER:  M. Hamman Son & Co.
ADDRESS:  Cloverport, Ky


ADDITIONAL COMMENTS/NOTES:




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