************************************************************************ 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.: HARDINSBURG Inc Town: City: No. St. Ward: Registration District No.: 130 Primary Registration District No: 5302 File No. 406 Registered No: 2. FULL NAME: DAVIS, LEGRALDA MERCER PERSONAL AND STATICAL PARTICULARS 3. SEX: FEMALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: WIDOW 6. DATE OF BIRTH: APR 14, 1823 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 91 / 7 / 23 8. OCCUPATION (a.) Trade, profession or particular kind of work: HOUSEKEEPING (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: NATHANIEL MERCER 11. BIRTHPLACE OF FATHER: VIRGINIA 12. MAIDEN NAME OF MOTHER: POLLY CASTILLO 13. BIRTHPLACE OF MOTHER: IRELAND 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) THOMAS P. DAVIS (Address) IRVINGTON 15. Filed JAN 8, 1915 REGISTAR: W.B. LENNON MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: JAN 7, 1915 17. I HEREBY CERTIFY, That I attended deceased from (date): JAN 4, 1915 tO JAN 7, 1915 That I last saw him/her alive on (date): JAN 7, 1915 And that death occurred on the date stated above at (time AM/PM): 10:13 PM THE CAUSE OF DEATH was as follows: ARTICULAR RHEUMATISM (Duration) Years: Months: Days: 7 Contributory: (Duration) Years: Months: Days: Signed (M.D.): J.E. MATTHEWS Date: JAN 8, 1915 Address: HARNED 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: EZRA DAVIS CEM DATE OF BURIAL: JAN 8, 1915 20. UNDERTAKER: ROBERT WEATHERFORD ADDRESS: HARNED ADDITIONAL COMMENTS/NOTES: ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************