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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  MOOK	
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5317
Primary Registration District No:  1
File No.  6244
Registered No:  
2.	FULL NAME:  LUCAS, MRS. LINA CARMAN
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  WIDOW
6.	DATE OF BIRTH:  APR 13, 1839
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  75 / 11 / 5
(b.)  General nature of industry business or establishment which employed:  PENTIONER
9.	BIRTHPLACE:  KENTUCKY
10.	NAME OF FATHER:  JOHN CARMAN
11.	BIRTHPLACE OF FATHER:  KENTUCKY
12.	MAIDEN NAME OF MOTHER:  BETSIE CARMAN
13.	BIRTHPLACE OF MOTHER:  KENTUCKY
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  JERAL LEN--AR   [?]
(Address)  CUSTER
15.	Filed  MAR 19, 1914
REGISTAR:  V.G. GOODMAN
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH: MAR 18, 1914 
17.	I HEREBY CERTIFY, That I attended deceased from (date):  MAY 22, 1913 to MAR 13, 1914
That I last saw him/her alive on (date):  DEC 12, 1913
And that death occurred on the date stated above at (time AM/PM):  6 AM
THE CAUSE OF DEATH was as follows:  VALVULAR DISEASE OF THE HEART
(Duration)   Years:  "SEVERAL"          Months:            Days:    
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  J.E. MATTHEWS
Date:  MAR 18, 1914
Address:  WESTVIEW
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:  LUCAS GRAVEYARD
DATE OF BURIAL:  MAR 19, 1914
20.	UNDERTAKER:  CLINT DRAIN
ADDRESS:  MOOK


ADDITIONAL COMMENTS/NOTES:




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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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