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1. PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Custer
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5315
Primary Registration District No:  15
File No.  5/9 88
Registered No:  41
2. FULL NAME:  Robert B Lockard
PERSONAL AND STATICAL PARTICULARS
3. SEX:  male
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  widowed
6. DATE OF BIRTH:  Jan 24, 1833
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  78 years, 11 months, 9 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  Carpenter
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Kentucky
10. NAME OF FATHER:  William Lockard
11. BIRTHPLACE OF FATHER:  Na
12. MAIDEN NAME OF MOTHER:  Martha Ann Turnhill
13. BIRTHPLACE OF MOTHER:  Na
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Aroela Benett
(Address)  Custer, Ky
15. Filed  Jan 5, 1913
REGISTAR:  J. T. Mitcham
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Jan 3, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  Dec 12, 1912 to Jan 2, 1913
That I last saw him/her alive on (date):  Jan 2, 1913
And that death occurred on the date stated above at (time AM/PM):  11 AM
THE CAUSE OF DEATH was as follows:  Paralysis
 
(Duration)   Years:            Months:            Days:  22
Contributory:  Artero Sclerosis
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  R. W. Meador
Date:  Jan 4, 1913
Address:  Custer, 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:  Hair Graveyard
DATE OF BURIAL:  Jan 4, 1913
20. UNDERTAKER:  [blank]
ADDRESS:  [blank]
 

ADDITIONAL COMMENTS/NOTES: According to Breckenridge County Cemeteries, Volume 1: Hair/Haire Cemetery is on Highway 86 on Jesse T. Pile's farm near Custer.
 
 
 

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File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net
 
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