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1.	PLACE OF DEATH
County:  Breck.
Vot. Pol.:  12
Inc Town:  Irvington, Ky
City:  
No.  
St.  
Ward:  
Registration District No.:  
Primary Registration District No:  5312
File No.  31421
Registered No:  5312
2.	FULL NAME:  Erskin Munford
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  M.
4.	COLOR OR RACE:  W
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Single
6.	DATE OF BIRTH:  June 16, 1865
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  48 yrs  5 mos  19 ds
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  
(b.)  General nature of industry business or establishment which employed:  Farmer
9.	BIRTHPLACE:  Ky.
10.	NAME OF FATHER:  Thealfus Munford
11.	BIRTHPLACE OF FATHER:  Ky
12.	MAIDEN NAME OF MOTHER:  Mary W. Washington
13.	BIRTHPLACE OF MOTHER:  Ky.
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Mrs. Mary W. Munford
(Address)  Irvington
15.	Filed  Dec. 6, 1913
REGISTAR:  D. W. Henry
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  Dec. 5, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  Nov. 1, 1913 to Dec. 5, 1913
That I last saw him/her alive on (date):  Dec. 5, 1913
And that death occurred on the date stated above at (time AM/PM):  3 p.m.
THE CAUSE OF DEATH was as follows:  Typhoid feaver followed by appendicitis & abcess of liver.

(Duration)   Years:            Months:  1          Days:  5
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A. A. Baxter, M.D.
Date:  12.6.1913
Address:  Guston, 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:  Washington Buring Ground
DATE OF BURIAL:  Dec. 6, 1913
20.	UNDERTAKER:  G. T. Marshall & Son
ADDRESS:  Irvington, Ky


ADDITIONAL COMMENTS/NOTES:




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