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1. PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Rockvale
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5320
Primary Registration District No:  
File No.  586
Registered No:  
2. FULL NAME:  Cathreen Logsdon
PERSONAL AND STATICAL PARTICULARS
3. SEX:  female
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  married yes
6. DATE OF BIRTH:  August 14, 1854
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  58 years, 4 months, 26 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  housewife
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Grayson County
10. NAME OF FATHER:  Nash Bennett
11. BIRTHPLACE OF FATHER:  Grayson County
12. MAIDEN NAME OF MOTHER:  Rachel Craig
13. BIRTHPLACE OF MOTHER:  Grayson County
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Robert Bennett
(Address)  VanZant
15. Filed  1/27/1912
REGISTAR:  J. D. McDonogh
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Jan 11, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  1910 - 1912
That I last saw him/her alive on (date):  June 2, 1912
And that death occurred on the date stated above at (time AM/PM):  2 AM
THE CAUSE OF DEATH was as follows:  Tuberculosis
 
(Duration)   Years:            Months:            Days:  
Contributory:  
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  C. DeWeese
Date:  Jan 11, 1913
Address:  Fordsville, 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:  Masedonia Cemetery
DATE OF BURIAL:  Jan 12, 1913
20. UNDERTAKER:  L. D. Orr
ADDRESS:  Jones, Ky
 

ADDITIONAL COMMENTS/NOTES: At the bottom of the certificate is written in....
'On acct of high water the mail Registrar filled in fount? J.D. McDonough
 
 
 

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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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