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1.	PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Mooleyville
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  
Primary Registration District No:  5310
File No.  6371
Registered No:  5310
2.	FULL NAME:  Edna Lorra Hylton
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  Female
4.	COLOR OR RACE:  W
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6.	DATE OF BIRTH:  Oct. 11, 1885
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  27 yrs  5 mos  7 ds
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  Housewife
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  VA
10.	NAME OF FATHER:  B. J. Bowling
11.	BIRTHPLACE OF FATHER:  VA
12.	MAIDEN NAME OF MOTHER:  Samie Williams
13.	BIRTHPLACE OF MOTHER:  VA
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  R. E. Elder
(Address)  Mooleyville Ky
15.	Filed  Mar 19, 1913
REGISTAR:  J. D. Cunningham  Mrs. S. R. OBryen
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  March 18, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  Marsh 16, 1913 to March 18, 1913
That I last saw him/her alive on (date):  March 18, 1913
And that death occurred on the date stated above at (time AM/PM):  9 p.m.
THE CAUSE OF DEATH was as follows:  Puerperal Eclampsia

(Duration)   Years:            Months:            Days:  2
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  D. S. Sphire M.D.
Date:  March 19, 1913
Address:  Mooleyville, 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:  House burying ground
DATE OF BURIAL:  Mar 20, 1913
20.	UNDERTAKER:  C. M. Hardesty
ADDRESS:  Cummons


ADDITIONAL COMMENTS/NOTES:




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