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1. PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  3
Registration District No.:  130
Primary Registration District No:  5303
File No.  14865
Registered No:  
2. FULL NAME:  Phillip Greenwell
PERSONAL AND STATICAL PARTICULARS
3. SEX:  male
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  married
6. DATE OF BIRTH:  April 22, 1844
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  70 years, 1 month, 23 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  farming
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Marian County, Ky
10. NAME OF FATHER:  Thomas Greenwell
11. BIRTHPLACE OF FATHER:  Kentucky
12. MAIDEN NAME OF MOTHER:  Nancy Brack
13. BIRTHPLACE OF MOTHER:  Unknown
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Charles Greenwell
(Address)  Hardinsburg, Ky
15. Filed  June 16, 1914
REGISTAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  6/15, 1914
17. I HEREBY CERTIFY, That I attended deceased from (date):  January to June 15, 1914
That I last saw him/her alive on (date):  June 15, 1914
And that death occurred on the date stated above at (time AM/PM):  7 1/2 PM
THE CAUSE OF DEATH was as follows:  Chronic Intestinal Nephritis
 
(Duration)   Years:   14 years or longer         Months:            Days:  
Contributory:  
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A. M. Kincheloe
Date:  6/15, 1914
Address:  Hardinsburg, 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:  St. Romaulds Cem.
DATE OF BURIAL:  June 16, 1914
20. UNDERTAKER:  J. T. Hoben
ADDRESS:  Hardinsburg, Ky
 

ADDITIONAL COMMENTS/NOTES:
(3131) written in above the File Number in the upper right hand corner
 
 

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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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