************************************************************************
Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
************************************************************************
1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  ROCKVALE
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5320
Primary Registration District No:  
File No.  20617
Registered No: 5320 
2.	FULL NAME:  JENEVIA MARLOW
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE: WHITE  
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED 
6.	DATE OF BIRTH: JANUARY 4, 1895 
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  18YRS 6MOS 9DS
8.	OCCUPATION (a.) Trade, profession or particular kind of work: HOUSEWIFE 
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  GRAYSON CO, KY
10.	NAME OF FATHER:  J.J. CHANCELLOR
11.	BIRTHPLACE OF FATHER:  KENTUCKY
12.	MAIDEN NAME OF MOTHER: MARY E. CHANCELLOR 
13.	BIRTHPLACE OF MOTHER:  KENTUCKY
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) J.T. BROWN 
(Address)  ASKIN
15.	Filed  JULY 18, 1913
REGISTAR: D.M. MCDONOH
	BY  ------
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH: JULY 13, 1913  
17.	I HEREBY CERTIFY, That I attended deceased from (date): JULY 10, 1913 TO JULY 13, 1913 
That I last saw her alive on (date): JULY 12, 1913 
And that death occurred on the date stated above at (time AM/PM):  3PM
THE CAUSE OF DEATH was as follows:  
PERITONITIS
(Duration)   Years:            Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days: 4  
Signed (M.D.): E.P. RODGERS 
Date:  JULY 13, 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: WELLS GRAVE YARD 
DATE OF BURIAL: 7-14-1913 
20.	UNDERTAKER: J.T. BROWN (ACTING) 
ADDRESS: ASKIN 


ADDITIONAL COMMENTS/NOTES:




************************************************************************

File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net

************************************************************************