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File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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1.  PLACE OF DEATH
County:  Breckinridge Co
Vot. Pol.:  
Inc Town:  Hardinsburg
City:  
No.  
St.  
Ward:  4
Registration District No.:  130
Primary Registration District No:  5304
File No.  11575
Registered No:  27 
2.  FULL NAME:  Ansellom Aloxious McGary
PERSONAL AND STATICAL PARTICULARS
3.  SEX:  Male
4.  COLOR OR RACE:  White
5.  SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6.  DATE OF BIRTH:  Apr 21, 1824
7.  AGE  (yr. mo. da) (If less than 1 day, hours or min?):  87 yrs 21 days
8.  OCCUPATION (a.) Trade, profession or particular kind of work:  Farmer
(b.)  General nature of industry business or establishment which employed:  
9.  BIRTHPLACE:  Brecinridge Co KY
10.  NAME OF FATHER:  William McGary
11.  BIRTHPLACE OF FATHER:  Ireland
12.  MAIDEN NAME OF MOTHER:  Andealy
13.  BIRTHPLACE OF MOTHER:  Maryland
14.  THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  John T. Hoben
(Address)  Hardinsburg, KY
15.  Filed  May 12, 1911
REGISTAR:  W. B . Lennon
MEDICAL CERTIFICATE OF DEATH
16.  DATE OF DEATH:  May 12, {illegible} 1911
17.  I HEREBY CERTIFY, That I attended deceased from (date):  May 12, 1910 to May 12, 1911
That I last saw him alive on (date):  May 12 {illegible} 1911
And that death occurred on the date stated above at (time AM/PM):  10 AM
THE CAUSE OF DEATH was as follows:  infirnitus of old age Cancer of left arm and face

(Duration)   Years:  1          Months:            Days:  
Contributory:  cro other causes {illegible} 

(Duration)   Years:   8         Months:            Days:  
Signed (M.D.):  James C. Sutton
Date:  May 12, 1911
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. Romuald's Cem
DATE OF BURIAL:  May 13, 1911
20.  UNDERTAKER:  J. T. Hoben
ADDRESS:  Hardinsburg, Ky

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Copyright.  All rights reserved.
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