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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  
Inc Town:  IRVINGTON
City:  
No.  
St.  
Ward:  
Registration District No.:  
Primary Registration District No:  5312
File No.  12331
Registered No:  5312
2.	FULL NAME:  KITTERMAN, CHARLES O.
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  MALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  MARRIED
6.	DATE OF BIRTH:  MAR 12, 1877
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  37 / 2 / 19
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  FARMER
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  INDIANA
10.	NAME OF FATHER:  J.W. KITTERMAN
11.	BIRTHPLACE OF FATHER:  INDIANA
12.	MAIDEN NAME OF MOTHER:  SARRAH SMITH
13.	BIRTHPLACE OF MOTHER:  INDIANA
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  mRS. KITTERMAN
(Address)  IRVINGTON
15.	Filed  MAY 31, 1914
REGISTAR:  D.W. 
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  MAY 31, 1914
17.	I HEREBY CERTIFY, That I attended deceased from (date):  MAY 26, 1914 to MAY 31, 1914
That I last saw him/her alive on (date):  MAY 30, 1914
And that death occurred on the date stated above at (t1 AMime AM/PM):  
THE CAUSE OF DEATH was as follows:  SUPPURATIVE TONSILITIS
(Duration)   Years:            Months:            Days:    6
Contributory:  EXHAUSTION

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  P.H. NEVITT
Date:  MAY 31, 1914
Address:  IRVINGTON
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:  NEW MIDDLETOWN, INDIANA
DATE OF BURIAL:  JUN 1, 1914
20.	UNDERTAKER:  G.T. MARSHALL & ALL
ADDRESS:  IRVINGTON


ADDITIONAL COMMENTS/NOTES:




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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net

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