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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  	5305
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  131
Primary Registration District No:  5305
File No.  21292
Registered No:  
2.	FULL NAME:  GREENWOOD, FRANK W.
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  MALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  WIDOWED
6.	DATE OF BIRTH:  OCT 27, 1828
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  86 / 10 / 13
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  FARMER
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  MEADE CO, KY
10.	NAME OF FATHER:  THOMAS GREENWOOD
11.	BIRTHPLACE OF FATHER:  VIRGINIA
12.	MAIDEN NAME OF MOTHER:  PHEBA WEBB
13.	BIRTHPLACE OF MOTHER:  NORTH CAROLINA
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  G.R. GREENWOOD
(Address)  CLOVERPORT
15.	Filed  SEP 11, 1915
REGISTAR:  J.C. NOLTE
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  SEP 10, 1915
17.	I HEREBY CERTIFY, That I attended deceased from (date):  AUG 26, 1915 to SEP 10, 1915
That I last saw him/her alive on (date):  SEP 9, 1915
And that death occurred on the date stated above at (time AM/PM):  2:20 P.M.
THE CAUSE OF DEATH was as follows:  ACUTE NEPHRITIS
(Duration)   Years:            Months:            Days:    18
Contributory:  
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  E.C. McDONALD
Date:  SEP 11, 1915
Address:  CLOVERPORT
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 ROSE CEM, BRECKINRIDGE COUNTY
DATE OF BURIAL:  SEP 11, 1915
20.	UNDERTAKER:  M. HAMMAN & SONS
ADDRESS:  CLOVERPORT


ADDITIONAL COMMENTS/NOTES:




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