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1. PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  230
Primary Registration District No:  5302
File No.  569
Registered No:  [unreadable]
2. FULL NAME:  Armilda V. Greer
PERSONAL AND STATICAL PARTICULARS
3. SEX:  female
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  married
6. DATE OF BIRTH:  Sept 28, 1848
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  64 years, 1 month, 5 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  
(b.)  General nature of industry business or establishment which employed:  Housekeeper
9. BIRTHPLACE:  [blank]
10. NAME OF FATHER:  [blank]
11. BIRTHPLACE OF FATHER:  [blank]
12. MAIDEN NAME OF MOTHER:  [blank]
13. BIRTHPLACE OF MOTHER:  [blank]
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  [blank]
(Address)  [blank]
15. Filed  Jan 4, 1913
REGISTAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Jany 3, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  Dec 13, 1912 to Jany 3, 1913
That I last saw him/her alive on (date):  Dec. 21, 1912
And that death occurred on the date stated above at (time AM/PM):  [unreadable] PM
THE CAUSE OF DEATH was as follows:  Cerebral Apoplexy
 
(Duration)   Years:            Months:            Days:  25
Contributory:  
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  W. E. Matthew
Date:  Jan 6, 1913
Address:  West View, 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:  Skillman Cemetery
DATE OF BURIAL:  Jan 4, 1913
20. UNDERTAKER:  Pete Sheeran Bro.
ADDRESS:  Kirk, KY
 

ADDITIONAL COMMENTS/NOTES:
 
 
 

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