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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.: 5307 
Inc Town:  
City:  CLOVERPORT
No.  
St.  
Ward:  
Registration District No.:  131
Primary Registration District No:  5307
File No.  17465
Registered No: 161 
2.	FULL NAME:  JOSEPHINE LEE
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  SINGLE
6.	DATE OF BIRTH:  JAN 9, 1913
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  1 / 7 / 6
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  KENTUCKY
10.	NAME OF FATHER:  FRANK LEE
11.	BIRTHPLACE OF FATHER:  KENTUCKY
12.	MAIDEN NAME OF MOTHER:  MARY GRAYBILL
13.	BIRTHPLACE OF MOTHER:  INDIANA
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  T.A. LANDRETH
(Address)  CLOVERPORT
15.	Filed  JUL 15, 1914
REGISTAR:  J.C. NOLTE
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  JUL 15, 1914
17.	I HEREBY CERTIFY, That I attended deceased from (date):  JUL 14, 1914 to JUL 15, 1914
That I last saw him/her alive on (date):  JUL 15, 1914
And that death occurred on the date stated above at (time AM/PM):  4 AM
THE CAUSE OF DEATH was as follows:  CHOLERA INFANTUM
(Duration)   Years:            Months:            Days:    3
Contributory:  HEAT & INDISCRETION IN FEEDING

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  C.R. LIGHTFOOT
Date:  JUL 15, 194
Address:  CLOVERPORT
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:  BURDETTE BURYING GROUND, BRECKINRIDGE COUNTY
DATE OF BURIAL:  JUL 15, 1914
20.	UNDERTAKER:  M. HAMMON & SONS
ADDRESS:   CLOVERPORT


ADDITIONAL COMMENTS/NOTES:




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