************************************************************************ 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. Pct: HARDINSBURG Inc Town: HARDINSBURG City: No. St. Ward: 3 Registration District No.: 130 Primary Registration District No: File No. 14337 Registered No: 99 2. FULL NAME: DURHAM, CHARLES PERSONAL AND STATISTICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: SINGLE 6. DATE OF BIRTH: OCT 9, 1846 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 65 / 6 / 29 8. OCCUPATION (a.) Trade, profession or particular kind of work: (b.) General nature of industry business or establishment which employed: FARMING 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: PHILLIP DURHAM 11. BIRTHPLACE OF FATHER: KENTUCKY 12. MAIDEN NAME OF MOTHER: EDITH HAYNES 13. BIRTHPLACE OF MOTHER: KENTUKCY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) JAMES DURHAM (Address) HARDINSBURG 15. Filed JUN 9, 1912 REGISTAR: W.B. LENNON MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: JUN 8, 1912 17. I HEREBY CERTIFY, That I attended deceased from (date): MAY 1, 1912 to JUN 8, 1912 That I last saw him/her alive on (date): JUN 8, 1912 And that death occurred on the date stated above at (time AM/PM): 12 AM THE CAUSE OF DEATH was as follows: CANCER OF BOWEL (Duration) Years: 3 Months: Days: Contributory: (Duration) Years: Months: Days: Signed (M.D.): JNO E. KINCHELOR Date: JUN 9, 1912 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: DURHAM CEM DATE OF BURIAL: 9 JUN 1912 20. UNDERTAKER: B.F. BEARD & CO ADDRESS: HARDINSBURG ************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************