************************************************************************ 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.: WEBSTER Inc Town: City: No. St. Ward: Registration District No.: 130 Primary Registration District No: 5308 File No. 17893 Registered No: 2. FULL NAME: DOWELL, SAVANNAH PERSONAL AND STATICAL PARTICULARS 3. SEX: FEMALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: WIDOWED 6. DATE OF BIRTH: JULY 9, 1837 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 80 YR 0 MO 21 DA 8. OCCUPATION (a.) Trade, profession or particular kind of work: (b.) General nature of industry business or establishment which employed: INVALID 9. BIRTHPLACE: KY 10. NAME OF FATHER: ISAIAH NORTON 11. BIRTHPLACE OF FATHER: KY 12. MAIDEN NAME OF MOTHER: MRS BASHAM 13. BIRTHPLACE OF MOTHER: KY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) HARRIS ROBINS (Address) CLIFTON MILLS, KY 15. Filed JULY 31, 1913 REGISTAR: W. B. LENNON MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: JULY 30, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): JULY 30, 1912 That I last saw him/her alive on (date): MARCH 1913 And that death occurred on the date stated above at (time AM/PM): 12:20PM THE CAUSE OF DEATH was as follows: BRIGHTS DISEASE (Duration) Years: 3 Months: Days: Contributory: (Duration) Years: Months: Days: Signed (M.D.): JOHN E. KINCHELOE Date: JULY 30, 1913 Address: 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: HORSLEY CEMETERY DATE OF BURIAL: JULY 31, 1913 20. UNDERTAKER: B. F. BEARD ADDRESS: HARDINSBURG, 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 ************************************************************************