************************************************************************ 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.: Inc Town: STEPHENSPORT City: No. St. Ward: Registration District No.: 5308 Primary Registration District No: File No. 20314 Registered No: 55 2. FULL NAME: MORRIS, LESTER PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: SINGLE 6. DATE OF BIRTH: JUL 9, 1893 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 21 / 1 / 9 8. OCCUPATION (a.) Trade, profession or particular kind of work: ON RAILROAD (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: ARAD MORRIS 11. BIRTHPLACE OF FATHER: KENTUCKY 12. MAIDEN NAME OF MOTHER: IDA DOWELL 13. BIRTHPLACE OF MOTHER: KENTUCKY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) TAYLOR DOWELL (Address) ADDISON, KENTUCKY 15. Filed AUG 18, 1914 REGISTAR: R.A. SKILLMAN MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: AUG 18, 1914 17. I HEREBY CERTIFY, That I attended deceased from (date): FEB 2, 1914 to AUG 18, 1914 That I last saw him/her alive on (date): AUG 14, 1914 And that death occurred on the date stated above at (time AM/PM): 4 AM THE CAUSE OF DEATH was as follows: TUBERCULOSIS (Duration) Years: 1 Months: 4 Days: Contributory: INJURY (Duration) Years: Months: Days: Signed (M.D.): GEO. E. SHIVELEY Date: Address: STEPHENSPORT 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: HALL GRAVEYARD DATE OF BURIAL: AUG 15, 1914 20. UNDERTAKER: C.A. TINIUS ADDRESS: STEPHENSPORT 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 ************************************************************************