************************************************************************ 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.: HARDINSBURG Inc Town: City: No. St. Ward: Registration District No.: 130 Primary Registration District No: 5302 File No. 21010 Registered No: 2. FULL NAME: GENTRY, WESLEY PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: SINGLE 6. DATE OF BIRTH: MAY 5, 1913 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 0 / 3 / 3 8. OCCUPATION (a.) Trade, profession or particular kind of work: (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: SHELLIE GENTRY 11. BIRTHPLACE OF FATHER: INDIANA 12. MAIDEN NAME OF MOTHER: DORA MORRIS 13. BIRTHPLACE OF MOTHER: KENTUCKY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) CHRISTY GENTRY (Address) KINGSWOOD, KY 15. Filed AUG 9, 1913 REGISTAR: W.B. LENNON MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: AUG 8, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): AUG 7, 1913 to AUG 8, 1913 That I last saw him/her alive on (date): AUG 7, 1913 And that death occurred on the date stated above at (time AM/PM): 8 PM THE CAUSE OF DEATH was as follows: ACUTE MILD INFECTION (Duration) Years: Months: 1 Days: Contributory: (Duration) Years: Months: Days: Signed (M.D.): J.C. MATTHEWS Date: AUG 9, 1913 Address: WESTVIEWS, KY 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: KINGSWOOD CEM DATE OF BURIAL: AUG 9, 1913 20. UNDERTAKER: B.F. BEARD & CO ADDRESS: -SMEARED- 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 ************************************************************************