************************************************************************ 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.: HARDINSBURG Inc Town: City: No. St. Ward: Registration District No.: 130 Primary Registration District No: 5304 File No. 6361 Registered No: 159 2. FULL NAME: EDWARD MANUAL MATTINGLY PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED 6. DATE OF BIRTH: MAY 16, 1842 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 71YRS 9MOS 26DS 8. OCCUPATION (a.) Trade, profession or particular kind of work: MERCHANT (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: JAMES MATTINGLY 11. BIRTHPLACE OF FATHER: KENTUCKY 12. MAIDEN NAME OF MOTHER: MISS BURCH 13. BIRTHPLACE OF MOTHER: KENTUCKY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) CHAS MATTINGLY (Address) HARDINSBURG KY 15. Filed MAR 12, 1913 REGISTAR: WB LENNON MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: MARCH 11, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): OCT 14, 1912 TO MARCH 11, 1913 That I last saw him alive on (date): MARCH 10, 1913 And that death occurred on the date stated above at (time AM/PM): 2 < > THE CAUSE OF DEATH was as follows: CIRRHOSIS LIVER (Duration) Years: 2 Months: Days: Contributory: (Duration) Years: Months: Days: Signed (M.D.): JNO E KINCHELOE Date: MAR 11, 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: ST. ROMUALDS CEMETERY DATE OF BURIAL: MAR 12, 1913 20. UNDERTAKER: JNO T. HOBEN ADDRESS: HARDINSBURG, KY 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 ************************************************************************