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1.	PLACE OF DEATH
County: BRECKINRIDGE 
Vot. Pol.:  HARDINSBURG
Inc Town:  
City:  
No.  
St.  
Ward:  3
Registration District No.: 130 
Primary Registration District No: 5301 
File No. 3581 
Registered No: 155 
2.	FULL NAME: ARTIMISSIE MARSHALL 
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED: WIDOWED 
6.	DATE OF BIRTH: 12/18/1844 
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?): 68YRS 2MOS 3DS 
8.	OCCUPATION (a.) Trade, profession or particular kind of work: LIVING WITH DAUGHTER 
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE: KENTUCKY 
10.	NAME OF FATHER:  ROBERT PAYNE
11.	BIRTHPLACE OF FATHER:  KENTUCKY
12.	MAIDEN NAME OF MOTHER:  NANCY SCOTT
13.	BIRTHPLACE OF MOTHER:  KENTUCKY
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  MRS. NANCY GIBSON
(Address) IRVINGTON, KY 
15.	Filed  FEB 22, 1913
REGISTAR:  W.B. LENNON
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  2/21/1913
17.	I HEREBY CERTIFY, That I attended deceased from (date): JAN 1911 TO FEB 21, 1913 
That I last saw her alive on (date): FEB 21, 1913  
And that death occurred on the date stated above at (time AM/PM): 12:30 PM  
THE CAUSE OF DEATH was as follows:  
CHRONIC INTERSTITIAL NEPHRITIS
(Duration)   Years: 2           Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A.M. KINCHELOE
Date:  2-21-1913
Address: HARDINSBURG, 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: MARSHALL CEM 
DATE OF BURIAL:  FEB 22, 1913
20.	UNDERTAKER:  B.F. BEARD & CO
ADDRESS:  HARDINSBURG, KY


ADDITIONAL COMMENTS/NOTES:
From Breck Co Cemeteries Book Vol 1, her name was Artamessa (Payne) Marshall.  She was married to Junius S. Marshall, who is buried next to her.



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