1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  130
Primary Registration District No:  5302
File No.  426
Registered No:  76
2. FULL NAME:  Hook, George T.
PERSONAL AND STATICAL PARTICULARS
3. SEX:  Male
4. COLOR OR RACE:  White
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6. DATE OF BIRTH:  Dec. 10, 1861
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  51 yr 1 mo 9 da
8. OCCUPATION (a.) Trade, profession or particular kind of work:  Farmer
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Hardinsburg, KY
10. NAME OF FATHER:  Johney Hook
11. BIRTHPLACE OF FATHER:   Hardinsburg, KY
12. MAIDEN NAME OF MOTHER:  Martha Jane Brunington
13. BIRTHPLACE OF MOTHER:  Hardinsburg, KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Barry Norton
(Address)  Garfield, KY
15. Filed  Jan. 22, 1912
REGISTRAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Jan. 19, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  Jan. 12, 1912
That I last saw him/her alive on (date):  Jan. 18, 1912
And that death occurred on the date stated above at (time AM/PM):  2 pm
THE CAUSE OF DEATH was as follows:  Lobar pneumonia

(Duration)   Years:            Months:            Days:  7
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  E. L. Harned
Date:  Jan. 19, 1912
Address:  Garfield, 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:  Freedom Cemetery
DATE OF BURIAL:  Jan. 20, 1912
20. UNDERTAKER:  I. B. Richardson
ADDRESS:  Garfield, KY