************************************************************************ 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.: Bewleyville Inc Town: Rosetta City: No. St. Ward: Registration District No.: 5313 Primary Registration District No: File No. 20736 Registered No: 15 2. FULL NAME: Lowrey, Larison L. PERSONAL AND STATICAL PARTICULARS 3. SEX: male 4. COLOR OR RACE: white 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: married 6. DATE OF BIRTH: Mch 28, 1882 [NOTE: Feb written in above Mch ] 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 29 yrs 5 mos 11 ds. 8. OCCUPATION (a.) Trade, profession or particular kind of work: Farmer (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: Grayson Co, KY 10. NAME OF FATHER: Edward Lowrey 11. BIRTHPLACE OF FATHER: Trumbull County, Ohio 12. MAIDEN NAME OF MOTHER: Sarah Reese 13. BIRTHPLACE OF MOTHER: Russel Co, KY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Chas. King (Address) Irvington, KY 15. Filed Aug. 11, 1911 REGISTAR: R. O. Penick crossed out. John Compton written in underneath MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: Aug. 11, 1911 17. I HEREBY CERTIFY, That I attended deceased from (date): June 2, 1911 to July 28 1911 That I last saw him/her alive on (date): July 28, 1911 And that death occurred on the date stated above at (time AM/PM): 2 p.m. THE CAUSE OF DEATH was as follows: Tuberculosis lungs (Duration) Years: Months: Days: Contributory: Tuberculosis Bowels ?? (Duration) Years: Months: Days: Signed (M.D.): Dr. J. W. Meador Date: 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: Rosetta DATE OF BURIAL: Aug. 12, 1911 20. UNDERTAKER: R. O. Penick ADDRESS: Custer, KY ************************************************************************ Copyright. All rights reserved. http://www.usgwarchives.net/copyright.htm http://www.usgwarchives.net/ky/kyfiles.html ************************************************