1. PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  HARDINSBURG, KY
Inc Town:  
City:  
No.  
St.  
Ward: 2
Registration District No.:  130
Primary Registration District No:  5302
File No.  20305
Registered No:  
2. FULL NAME:  MILLER, JUDITH M.
PERSONAL AND STATICAL PARTICULARS
3. SEX:  FEMALE
4. COLOR OR RACE:  WHITE
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  WIDOWED
6. DATE OF BIRTH:  AUG. 28, 1825
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  88 YR, 11 MO, 26 DA
8. OCCUPATION (a.) Trade, profession or particular kind of work:  INFIRM (?)
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  BRECKINRIDGE CO., KY
10. NAME OF FATHER:  JOHN DEJARNETTE
11. BIRTHPLACE OF FATHER:  RICHMOND, VA
12. MAIDEN NAME OF MOTHER:  JUDITH MOORMAN
13. BIRTHPLACE OF MOTHER:  RICHMOND, VA
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  TAYLOR BEARD
(Address)  HARDINSBURG, KY
15. Filed  AUG. 25, 1914
REGISTRAR:  W. B. LENNON
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  AUG. 24, 1914
17. I HEREBY CERTIFY, That I attended deceased from (date):  JUNE 1914
That I last saw him/her alive on (date):  AUG. 24, 1914
And that death occurred on the date stated above at (time AM/PM):  2 PM
THE CAUSE OF DEATH was as follows:  ARTERIOSCLEROSIS

(Duration)   Years:      2      Months:           Days:  
Contributory:  AGE

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A. M. KINCHELOE
Date:  AUG. 26, 1914
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:  HARDINSBURG CEMETERY
DATE OF BURIAL:  AUG. 25, 1914
20. UNDERTAKER:  B. F. BEARD & CO.
ADDRESS:  HARDINSBURG, KY