************************************************************************ 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.: Cloverport Inc Town: City: No. St. Ward: Registration District No.: 131 Primary Registration District No: 5306 File No. 15006 Registered No: 109 2. FULL NAME: DENHAM, D. WARREN PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED 6. DATE OF BIRTH: AUG 16, 1861 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 52 YR 10 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: HARDIN DENHAM 11. BIRTHPLACE OF FATHER: KY 12. MAIDEN NAME OF MOTHER: ALBANA SMITH 13. BIRTHPLACE OF MOTHER: KY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) W. S. SMART (Address) HARDINSBURG, KY 15. Filed JUNE 10, 1913 REGISTAR: J. C. NOLTE MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: JUNE 10, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): JUNE 7, 1913 That I last saw him/her alive on (date): JUNE 10, 1913 And that death occurred on the date stated above at (time AM/PM): 11:43 PM THE CAUSE OF DEATH was as follows: ACUTE HEPATITIS (Duration) Years: Months: Days: 10 Contributory: (Duration) Years: Months: Days: Signed (M.D.): JOHN E. KINCHELOE Date: JUNE 10, 1913 Address: HARDINSBURG, 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: BRECKINRIDGE CO., KY DATE OF BURIAL: JUNE 11, 1913 20. UNDERTAKER: M. HAMMAN SONS ADDRESS: CLOVERPORT, KY 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 ************************************************************************