************************************************************************
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.:  (WEBSTER)  UNION STAR
Inc Town:  WEBSTER
City:  
No.  
St.  
Ward:  
Registration District No.:  
Primary Registration District No:  5309
File No.  6370
Registered No:  
2.	FULL NAME:  PAYNE, CINTHIE BROWN
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  MARRIED
6.	DATE OF BIRTH:  MAR 1, 1847
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  66 / 0 / 24
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  HOUSEWIFE
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  MEADE COUNTY
10.	NAME OF FATHER:  SAM BROWN
11.	BIRTHPLACE OF FATHER:  MEADE COUNTY
12.	MAIDEN NAME OF MOTHER:  IOLA KILLAM
13.	BIRTHPLACE OF MOTHER:  HARDIN COUNTYU
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  NANNIE PAYNE
(Address)  LODIBURG
15.	Filed  MAR 25, 1913
REGISTAR:  H. -. - - - - - 
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  MAR 25, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  MAR 19, 1913 to MAR 20, 1913
That I last saw him/her alive on (date):  MAR 20, 1913
And that death occurred on the date stated above at (time AM/PM):  2:25 AM
THE CAUSE OF DEATH was as follows:  APOPLEXY
(Duration)   Years:            Months:            Days:    5
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  T.J. HENDRICK
Date:  MAR 25, 1913
Address:  WEBSTER
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:  WALNUT GROVE
DATE OF BURIAL:  MAR 26, 1913
20.	UNDERTAKER:  G.T. MARSHALL
ADDRESS:  IRVINGTON


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

************************************************************************