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1.	PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Irvington
Inc Town:  Irvington
City:  
No.  
St.  
Ward:  
Registration District No.:  5312
Primary Registration District No:  
File No.  31420
Registered No:  5312
2.	FULL NAME:  Eliga Moremen
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  Male
4.	COLOR OR RACE:  Negro
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Widower
6.	DATE OF BIRTH:  1854
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  59 yrs  4 mos  no ds
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  Farm laorer
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  
10.	NAME OF FATHER:  
11.	BIRTHPLACE OF FATHER:  
12.	MAIDEN NAME OF MOTHER:  
13.	BIRTHPLACE OF MOTHER:  
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  James Robinson
(Address)  Basin Spring
15.	Filed  Dec. 4th, 1913
REGISTAR:  D. W. Henry
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  Dec. 4, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  Nov. 4, 1913 to Dec. 4, 1913
That I last saw him/her alive on (date):  Dec. 3, 1913
And that death occurred on the date stated above at (time AM/PM):  2 a.m.
THE CAUSE OF DEATH was as follows:  Typhoid fever

(Duration)   Years:            Months:  1          Days:  10
Contributory:  Lagrippe

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  P. H. Nevitt, M.D.
Date:  Dec. 4, 1913
Address:  Irvington
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:  Glen Deane, Ky
DATE OF BURIAL:  Dec. 5, 1913
20.	UNDERTAKER:  G. T. Marshel & Son
ADDRESS:  Irvington


ADDITIONAL COMMENTS/NOTES:




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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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