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1. PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  McDaniels
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5318
Primary Registration District No:  
File No.  15022
Registered No:  
2. FULL NAME:  Eliza M. Priest
PERSONAL AND STATICAL PARTICULARS
3. SEX:  female
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  married
6. DATE OF BIRTH:  Nov. 30, 1872
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  40 years, 6 months, 12 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  Housekeeper
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Kentucky
10. NAME OF FATHER:  Harrison T. Smiley
11. BIRTHPLACE OF FATHER:  Westview, Ky
12. MAIDEN NAME OF MOTHER:  Emaline Conner
13. BIRTHPLACE OF MOTHER:  Westview, Ky
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  
(Address)  
15. Filed  June 13, 1913
REGISTAR:  M. M. Jarboe
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  June 12, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  March 19, 1912 to June 12, 1913
That I last saw him/her alive on (date):  June 10, 1913
And that death occurred on the date stated above at (time AM/PM):  3:45 PM
THE CAUSE OF DEATH was as follows:  Pulmonary Tuberculoses
 
(Duration)   Years:    about 2 years        Months:            Days:  
Contributory:  
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  J. E. Mathews
Date:  June 12, 1913
Address:  West View, 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:  
DATE OF BURIAL:  
20. UNDERTAKER:  
ADDRESS:  
 

ADDITIONAL COMMENTS/NOTES:
There is no place of burial listed on the death certificate but, Breckenridge County Cemeteries Volume 1, page 367 shows the following: Priest, Eliza S, 1872 - 1913 is buried in Fairview United Methodist Church Cemetery about 3 miles east of West View on KY 259.
 
 
 

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