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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  CUSTER
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5315
Primary Registration District No:  15
File No.  969
Registered No:  82
2.	FULL NAME:  HUFFINES, JAMES A.
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  MALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  SINGLE
6.	DATE OF BIRTH:  SEP 14, 1913
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  1 / 2 / 9
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  GARFIELD, BRECKINRIDGE, KY
10.	NAME OF FATHER:  IRVIN HUFFINES
11.	BIRTHPLACE OF FATHER:  GARFIELD, BRECKINRIDGE, KY
12.	MAIDEN NAME OF MOTHER: MINNIE HAYNES 
13.	BIRTHPLACE OF MOTHER:  GARFIELD, BRECKINRIDGE, KY
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  BEN HUFFINES
(Address)  GARFIELD, BRECKINRIDGE, KY
15.	Filed  NOV 24, 1914
REGISTAR:  J.D. MITCHAM
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  NOV 23, 1914
17.	I HEREBY CERTIFY, That I attended deceased from (date):  NOV 9, 1914 to NOV 23, 1914
That I last saw him/her alive on (date):  NOV 23, 1914
And that death occurred on the date stated above at (time AM/PM):  8 AM
THE CAUSE OF DEATH was as follows:  BRONCHO PNEUMONIA
(Duration)   Years:            Months:            Days:    14
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  J.A. SANDBACH
Date:  MAR 23, 1914
Address:  GARFIELD, KENTUCKY, 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:  HUFFINES CEM
DATE OF BURIAL:  NOV 24, 1914
20.	UNDERTAKER:  J.S. GRAY
ADDRESS:  CUSTER


ADDITIONAL COMMENTS/NOTES:




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