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File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:Hardinsburg
Inc Town:  Incorporated
City:
No.  130
St.
Ward
Registration District No.:
Primary Registration District No:
File No.  27311
Registered No:
2. FULL NAME:  Findley, Louis
PERSONAL AND STATICAL PARTICULARS
3. SEX:   Male
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:
6. DATE OF BIRTH:  Oct. 27, 1911
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  4 hours
8. OCCUPATION (a.) Trade, profession or particular kind of work:
(b.)  General nature of industry business or establishment which employed:
9. BIRTHPLACE:   Breckinridge County, KY
10. NAME OF FATHER:  Perry W. Findley
11. BIRTHPLACE OF FATHER:  KY
12. MAIDEN NAME OF MOTHER:  Lulu M. Robbins
13. BIRTHPLACE OF MOTHER:  KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  H. B. Kurtz, M. D. 
(Address)   Clifton Mills, KY
15. Filed  11/7/1911
REGISTAR:  Hollis Davis ??
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Oct 27, 1911
17. I HEREBY CERTIFY, That I attended deceased from (date):  Oct 27, 1911  to at birth 1911
That I last saw him/her alive on (date):  Oct 27, 1911
And that death occurred on the date stated above at (time AM/PM):  11:50 p.m.
THE CAUSE OF DEATH was as follows:
Collapsed lung
(Duration)
Years:
Months:
Days:
Signed (M.D.):  H. B. Kurtz, M. D.  
Date:   
Address:  Clifton Mills
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
DATE OF BURIAL:  Oct 28, 1911
20. UNDERTAKER:  S. L. Hook??
ADDRESS:  

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Copyright.  All rights reserved.
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