1. PLACE OF DEATH
County: Breckinridge
Vot. Pol.: Hardinsburg, Ky
Inc Town: Hardinsburg, Ky
City:
No.
St.
Ward: 2
Registration District No.: 130
Primary Registration District No: 5302
File No. 14338
Registered No: 101
1. FULL NAME: Amanda Jane Lennon
PERSONAL AND STATICAL PARTICULARS
2. SEX: female
3. COLOR OR RACE: white
4. SINGLE, MARRIED, WIDOWED, OR DIVORCED: married
5. DATE OF BIRTH: November 17, 1839
6. AGE  (yr. mo. da) (If less than 1 day, hours or min?): 72yrs7mos
7. OCCUPATION (a.) Trade, profession or particular kind of work: house keeping
(b.)  General nature of industry business or establishment which employed:
8. BIRTHPLACE: Ohio
9. NAME OF FATHER: Joseph Hook
10. BIRTHPLACE OF FATHER: Virginia
11. MAIDEN NAME OF MOTHER: Sarah Downing
12. BIRTHPLACE OF MOTHER: Maryland
13. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) J.H. Lennon
(Address) Hardinsburg, Ky
14. Filed June 17, 1912
REGISTAR: WB Lennon
MEDICAL CERTIFICATE OF DEATH
15. DATE OF DEATH: 6/17/1912
16. I HEREBY CERTIFY, That I attended deceased from (date): 1906 to June 17, 1912
That I last saw him/her alive on (date): June 16, 1912
And that death occurred on the date stated above at (time AM/PM): 6am
THE CAUSE OF DEATH was as follows:
Chronic nephritis
(Duration)
Years: 6
Months:
Days:
Signed (M.D.): A. M. Kincheloe
Date: 6-7-1912
Address: Hardinsburg, Ky
17. 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:
18. PLACE OF BURIAL OR REMOVAL: Ivy Hill Cemetery
DATE OF BURIAL: June 18, 1912
19. UNDERTAKER: B.F. Beard & Co
ADDRESS: Hardinsburg, Ky