************************************************************************ 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.: MCDANIELS Inc Town: City: No. St. Ward: Registration District No.: 17484 Primary Registration District No: File No. Registered No: 2. FULL NAME: NOTTINGHAM, WILBER LEE PERSONAL AND STATICAL PARTICULARS 3. SEX: MALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: SINGLE 6. DATE OF BIRTH: MAY 11, 1914 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): - / 2 / 2 8. OCCUPATION (a.) Trade, profession or particular kind of work: (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: SAMUEL M. NOTTINGHAM 11. BIRTHPLACE OF FATHER: KENTUCKY 12. MAIDEN NAME OF MOTHER: COVA PRIEST 13. BIRTHPLACE OF MOTHER: KENTUCKY 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) SAM NOTTINGHAM (Address) 15. Filed JUL 15, 1914 REGISTAR: M.M. JARBOE MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: JUL 14, 1914 17. I HEREBY CERTIFY, That I attended deceased from (date): JUL 12, 1914 tO JUL 14, 1914 That I last saw him/her alive on (date): JUL 13, 1914 And that death occurred on the date stated above at (time AM/PM): THE CAUSE OF DEATH was as follows: INTESTINAL TEXECU-- (Duration) Years: Months: Days: 6 Contributory: CONVULSIONS (Duration) Years: Months: Days: Signed (M.D.): J.S. MATTHEWS Date: JUL 14, 1914 Address: WESTVIEW 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: NO DATA PROVIDED DATE OF BURIAL: 20. UNDERTAKER: ADDRESS: 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 ************************************************************************