************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ 1. PLACE OF DEATH County: Breckinridge Vot. Pol.: Webster Inc Town: City: No. St. Ward: Registration District No.: 5311 Primary Registration District No: File No. 17902 Registered No: 2. FULL NAME: Marthie Knott PERSONAL AND STATICAL PARTICULARS 3. SEX: woman 4. COLOR OR RACE: white 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: 6. DATE OF BIRTH: July 29, 1863 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 49 years, 11 months, 20 days 8. OCCUPATION (a.) Trade, profession or particular kind of work: housewife (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: Meade County 10. NAME OF FATHER: William Gilpin 11. BIRTHPLACE OF FATHER: [blank] 12. MAIDEN NAME OF MOTHER: Sallie Haynes 13. BIRTHPLACE OF MOTHER: [blank] 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Mollie Ali (Address) Webster 15. Filed 7/9, 1913 REGISTAR: J. H. Comer MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: 7 - 9 - 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): Mar 1 to July 9, 1913 That I last saw him/her alive on (date): July 8, 1913 And that death occurred on the date stated above at (time AM/PM): 8 AM THE CAUSE OF DEATH was as follows: Consumption (Duration) Years: Months: 6 Days: 8 Contributory: (Duration) Years: Months: Days: Signed (M.D.): T. J. Hendrick Date: July 9, 1913 Address: Webster, 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: Webster, KY DATE OF BURIAL: 7-10, 1913 20. UNDERTAKER: G. T. Marshall & Son ADDRESS: Irvington, KY ADDITIONAL COMMENTS/NOTES: Breckinridge County, KY Cemeteries, Volume 1 has Martha Knott buried in the Webster United Methodist Church Cemetery, page 254, Knott, Martha, 7/29/1863 - 07/09/1913, W[ife] of - Scott ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************