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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.  26159
Registered No:  5310
2.	FULL NAME:  Isabell Jarboe
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  Female
4.	COLOR OR RACE:  White
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  
6.	DATE OF BIRTH:  Oct 24, 1837
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  75 yrs  11 mos  24 ds
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  House Wife
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  Ky
10.	NAME OF FATHER:  John Caffee
11.	BIRTHPLACE OF FATHER:  Ind
12.	MAIDEN NAME OF MOTHER:  Reiley
13.	BIRTHPLACE OF MOTHER:  Ky.
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  J. T. Jarboe
(Address)  Chenault, Ky.
15.	Filed  Nov. 10, 1913
REGISTAR:  J. D. Cunningham  Mrs. S. R. OBryan
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  Oct 17, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  Oct. 15, 1913 to Oct. 17, 1913
That I last saw him/her alive on (date):  Oct. 17, 1913
And that death occurred on the date stated above at (time AM/PM):  11 a.m.
THE CAUSE OF DEATH was as follows:  Hemorrhage of the Brain

(Duration)   Years:            Months:            Days:  1 ½ 
Contributory:  Arterio sclerosis

(Duration)   Years:   1         Months:            Days:  
Signed (M.D.):  D. S. Sphire
Date:  Oct. 17, 1913
Address:  Mooleyville
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:  Hardinsburg, Ky
DATE OF BURIAL:  Oct. 19, 1913
20.	UNDERTAKER:  John C. Manning
ADDRESS:  Chenaultt, Ky


ADDITIONAL COMMENTS/NOTES:




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