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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  5306
Inc Town:  
City:  CLOVERPORT, KY
No.  
St.  
Ward:  2
Registration District No.: 131 
Primary Registration District No:  
File No. 15008 
Registered No: 113  
2.	FULL NAME:  SUSAN HIGDON
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE: COLORED 
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED: WIDOW 
6.	DATE OF BIRTH:  SEPT 22, 1826
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?): 86YRS 9MOS 8DS 
8.	OCCUPATION (a.) Trade, profession or particular kind of work: NONE 
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE: KENTUCKY 
10.	NAME OF FATHER: WARREN SINGLETON 
11.	BIRTHPLACE OF FATHER: KENTUCKY 
12.	MAIDEN NAME OF MOTHER:  MARIAH TAUZY
13.	BIRTHPLACE OF MOTHER: KENTUCKY 
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) <Emerson> HIGDON 
(Address)  CLOVERPORT, KY
15.	Filed  JULY 1, 1913
REGISTAR:  JC NOLTE
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH: JUNE 30, 1913 
17.	I HEREBY CERTIFY, That I attended deceased from (date):  FEB 1913
That I last saw him/her alive on (date):  
And that death occurred on the date stated above at (time AM/PM):  7AM
THE CAUSE OF DEATH was as follows:  
OLD AGE, WORN OUT, SENILITY
(Duration)   Years:            Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  B.T. RAFFERTY
Date: JUNE 30, 1913 
Address: CLOVERPORT, 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: COLORED CEMETERY NEAR CLOVERPORT, KY 
DATE OF BURIAL: JULY 1, 1913 
20.	UNDERTAKER:  M. HAMMAN SONS
ADDRESS:  CLOVERPORT, KY


ADDITIONAL COMMENTS/NOTES:




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