************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************************************ 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 ************************************************************************ File contributed for use in USGenWeb Archives by: Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067 http://www.usgwarchives.net ************************************************************************