************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************ 1. PLACE OF DEATH County: Breckinridge Vot. Pol.: Big Spring Inc Town: Near Big Spring, Ky City: No. St. Ward: Registration District No.: 5314 Primary Registration District No: 14 File No. 24220 Registered No: 9 2. FULL NAME: William Alther Lockard PERSONAL AND STATICAL PARTICULARS 3. SEX: male 4. COLOR OR RACE: white 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: widowed 6. DATE OF BIRTH: April 20, 1875 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 37 years, 5 months, 13 days 8. OCCUPATION (a.) Trade, profession or particular kind of work: farmer (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: Ky 10. NAME OF FATHER: Ferda Lockard 11. BIRTHPLACE OF FATHER: Ky 12. MAIDEN NAME OF MOTHER: Bittie Jordon 13. BIRTHPLACE OF MOTHER: Ky 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Losh Trent (Address) Custer, Ky 15. Filed Oct 7, 1912 REGISTAR: J. D. Morris MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: October 3, 1912 17. I HEREBY CERTIFY, That I attended deceased from (date): Sept 25 to Oct 3, 1912 That I last saw him/her alive on (date): Oct 3, 1912 And that death occurred on the date stated above at (time AM/PM): 6 pm THE CAUSE OF DEATH was as follows: Typhoid Fever (Duration) Years: Months: Days: 12 Contributory: Pneumonia (Duration) Years: Months: Days: Signed (M.D.): R. W. Meador Date: Oct 4, 1912 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: Rozetta Cemetery DATE OF BURIAL: Oct 4, 1912 20. UNDERTAKER: Alf Taylor ADDRESS: Custer, Ky ************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************