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File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net

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1.	PLACE OF DEATH
County:  	Breckinridge
Vot. Pol.:  	Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  		2
Registration District No.: 130
Primary Registration District No: 5302
File No.  		6169
Registered No:  		87
2.	FULL NAME: Abner Davis
PERSONAL AND STATICAL PARTICULARS
3.	SEX: Male
4.	COLOR OR RACE: White  
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED: Married  
6.	DATE OF BIRTH: August 26, 1873
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?): 39 years, 6 mo, 22 days
8.	OCCUPATION (a.) Trade, profession or particular kind of work: Laborer in Livery Stable
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  		Kentucky
10.	NAME OF FATHER:  			R M Davis
11.	BIRTHPLACE OF FATHER:  		Kentucky
12.	MAIDEN NAME OF MOTHER:   L Anne Collins
13.	BIRTHPLACE OF MOTHER:   Kentucky
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  		Taylor Meador
(Address)  		Hardinsburg, KY
15.	Filed  			March 16, 1912
REGISTAR:  			W B Lennon
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  			March 16, 1912
17.	I HEREBY CERTIFY, That I attended deceased from (date): March 7, 1912 to March 16, 1912
That I last saw him/her alive on (date):  				March 15, 1912
And that death occurred on the date stated above at (time AM/PM): 5:00 AM
THE CAUSE OF DEATH was as follows:  			***** Pneumonia

(Duration)   Years:            Months:            Days: 9
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.): J E Kincheloe
Date: March 16, 1912
Address: Hardinsburg, Kentucky
18.	LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients, or Recent Residents)
At place of death (yr, mo, da.): 11 days
In the State (yr, mo, da): 11 days
Where was disease contracted,  if not at place of death?  
Former or usual residence:  	Evansville, Indiana
19.	PLACE OF BURIAL OR REMOVAL:  
DATE OF BURIAL: March 17, 1912
20.	UNDERTAKER: B F Beard & Co.
ADDRESS:  		Hardinsburg, KY 

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Copyright.  All rights reserved.
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