************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************ 1. PLACE OF DEATH County: Breckinridge Vot. Pol.: Hardinsburg Inc Town: City: No. St. Ward: 2 Registration District No.: 138 Primary Registration District No: File No. 17179 Registered No: 41 1. FULL NAME: Viola Lee Driskell PERSONAL AND STATICAL PARTICULARS 2. SEX: female 3. COLOR OR RACE: white 4. SINGLE, MARRIED, WIDOWED, OR DIVORCED: married 5. DATE OF BIRTH: Sept 8, 1880 6. AGE (yr. mo. da) (If less than 1 day, hours or min?): 31yrs10mos 7. OCCUPATION (a.) Trade, profession or particular kind of work: house wife (b.) General nature of industry business or establishment which employed: 8. BIRTHPLACE: Kentucky 9. NAME OF FATHER: John Whitely 10. BIRTHPLACE OF FATHER: Kentucky 11. MAIDEN NAME OF MOTHER: Artie May Bruce 12. BIRTHPLACE OF MOTHER: Kentucky 13. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Ernest Driskell (Address) Harned, Ky 14. Filed July 8, 1911 REGISTAR: WR Lennon MEDICAL CERTIFICATE OF DEATH 15. DATE OF DEATH: July 8, 1911 16. I HEREBY CERTIFY, That I attended deceased from (date): April 1911, to July 8, 1911 That I last saw him/her alive on (date): July 5, 1911 And that death occurred on the date stated above at (time AM/PM): 4AM THE CAUSE OF DEATH was as follows: Pulmonary Tuberculosis (Duration) Years: 1 Months: 3 Days: 0 Signed (M.D.): Jno E. Kincheloe Date: July 8, 1911 Address: Hardinsburg, Ky 17. 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: 18. PLACE OF BURIAL OR REMOVAL: Ephesus Cemetery DATE OF BURIAL: July 9, 1911 19. UNDERTAKER: Robt Weatherford ADDRESS: Harned, Ky ************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************