1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  4
Registration District No.:  130
Primary Registration District No:  5304
File No.  6175
Registered No:  85
2. FULL NAME:  Hoben, Ida Pauline
PERSONAL AND STATICAL PARTICULARS
3. SEX:  Female
4. COLOR OR RACE:  White
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6. DATE OF BIRTH:  Oct. 27, 1866
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  45 yr 4 mo 12 da
8. OCCUPATION (a.) Trade, profession or particular kind of work:  
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Concordia, KY
10. NAME OF FATHER:  Thomas Alexander McGill
11. BIRTHPLACE OF FATHER:  Bracken Co., KY
12. MAIDEN NAME OF MOTHER:  Catherine Emeline McGill
13. BIRTHPLACE OF MOTHER:  Nelson Co., KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Mrs. Effie Rhodes
(Address)  Hardinsburg, KY
15. Filed  Mar 9, 1912
REGISTRAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Mar 9, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  Sept. 11, 1911
That I last saw him/her alive on (date):  Mar 9, 1912
And that death occurred on the date stated above at (time AM/PM):  8 am
THE CAUSE OF DEATH was as follows:  Chronic nephritis

(Duration)   Years:            Months:    6        Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A. M. Kincheloe
Date:  Mar 9, 1912
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. Romuald's Cemetery
DATE OF BURIAL:  Mar 12, 1912
20. UNDERTAKER:  J. T. Hoben
ADDRESS:  Hardinsburg, KY