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File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net

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1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Custer
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  15
Primary Registration District No:  5315
File No.  14273
Registered No:  
2. FULL NAME:  Nimmo, Clement
PERSONAL AND STATICAL PARTICULARS
3. SEX:  Male
4. COLOR OR RACE:  White
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  Married
6. DATE OF BIRTH:  Apr. 8, 1844
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  67 yr 2 mo 11 da
8. OCCUPATION (a.) Trade, profession or particular kind of work:  Farmer
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Hardin Co., KY
10. NAME OF FATHER:  Robert Nimmo
11. BIRTHPLACE OF FATHER:  Virginia
12. MAIDEN NAME OF MOTHER:  Marsha Holland
13. BIRTHPLACE OF MOTHER:  Virginia
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Z. T. Nimmo
(Address)  Custer, KY
15. Filed  Jan. 19, 1912
REGISTAR:  R. O. Penick
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  June 19, 1911
17. I HEREBY CERTIFY, That I attended deceased from (date):  May 9, 1911
That I last saw him/her alive on (date):  May 9, 1911
And that death occurred on the date stated above at (time AM/PM):  
THE CAUSE OF DEATH was as follows:  Paresis

(Duration)   Years:     4       Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  J. W. Meador
Date:  June 20, 1911
Address:  Custer, 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:  Hair Cemetery
DATE OF BURIAL:  June 20, 1911
20. UNDERTAKER:  R. B. Lockhart
ADDRESS:  Custer, KY

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Copyright.  All rights reserved.
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