1. PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  BIG SPRING
Inc Town:  
City:  
No.  
St.  
Ward:
Registration District No.:  5314
Primary Registration District No:  14
File No.  9455
Registered No:  
2. FULL NAME:  MINTER, EVERETT
PERSONAL AND STATICAL PARTICULARS
3. SEX:  MALE
4. COLOR OR RACE:  WHITE
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  MARRIED
6. DATE OF BIRTH:  AUG. 31, 1876
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  37 YR 7 MO 6 DA
8. OCCUPATION (a.) Trade, profession or particular kind of work:  FARMER
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  BRECKINRIDGE CO., KY
10. NAME OF FATHER:  WILLIAM MINTER
11. BIRTHPLACE OF FATHER:  VA
12. MAIDEN NAME OF MOTHER:  MARY J. MILLER
13. BIRTHPLACE OF MOTHER:  KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  B. J. NORRIS
(Address)  BIG SPRING, KY
15. Filed  APR. 11, 1914
REGISTRAR:  
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  APR. 7, 1914
17. I HEREBY CERTIFY, That I attended deceased from (date):  APR. 4, 1914
That I last saw him/her alive on (date):  APR 6, 1914
And that death occurred on the date stated above at (time AM/PM):  1:30 AM
THE CAUSE OF DEATH was as follows:  ACUTE INDIGESTION

(Duration)   Years:            Months:           Days:  3
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  C. B. WITT  
Date:  APR. 7, 1914
Address:  BIG SPRING, 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:  KASEY CEMETERY
DATE OF BURIAL:  APR 7, 1914
20. UNDERTAKER:  DOLPH RICHARDSON
ADDRESS:  BIG SPRING, KY