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1.	PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Hardinsburg, KY
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  130
Primary Registration District No:  5301
File No.  28689
Registered No:  
2.	FULL NAME:  Elsie Duncan
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  Male
4.	COLOR OR RACE:  Negro
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6.	DATE OF BIRTH:  Aug 6, 1880
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  33 yrs, 3 mos, 10 ds
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  Rail Road
(b.)  General nature of industry business or establishment which employed:  Section Hand
9.	BIRTHPLACE:  Breckenridge
10.	NAME OF FATHER:  Martin Duncan
11.	BIRTHPLACE OF FATHER:  Nelson County
12.	MAIDEN NAME OF MOTHER:  Bettie Moorman
13.	BIRTHPLACE OF MOTHER:  Breckenridge Co
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Leonard Robertson
(Address)  McQuady, Ky
15.	Filed:  Nov 17, 1913
REGISTAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  Nov 16, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  Nov 1, 1913 to Nov 16, 1913
That I last saw him alive on (date):  1913
And that death occurred on the date stated above at (time AM/PM):  4 AM
THE CAUSE OF DEATH was as follows:  Pulmonary Phthisis

(Duration)   Years:            Months:  10          Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  John E. Kincheloe
Date:  Nov 16, 1913
Address:  Hardinsburg
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:  McQuady, Ky
DATE OF BURIAL:  Nov 17, 1913
20.	UNDERTAKER:  B. F. BEARD & Co.
ADDRESS:  Hardinsburg


ADDITIONAL COMMENTS/NOTES:




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