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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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1. PLACE OF DEATH
County: Breckinridge
Vot. Pol.: Custer, Ky
Inc Town:
City:
No. 5315
St.
Ward
Registration District No.:
Primary Registration District No:
File No. 14274
Registered No: 9
1. FULL NAME: Emit Priest
PERSONAL AND STATICAL PARTICULARS
2. SEX: male
3. COLOR OR RACE: white
4. SINGLE, MARRIED, WIDOWED, OR DIVORCED: single
5. DATE OF BIRTH: February 2, 1893
6. AGE  (yr. mo. da) (If less than 1 day, hours or min?): 18yrs4mos22ds
7. OCCUPATION (a.) Trade, profession or particular kind of work: farmer
(b.)  General nature of industry business or establishment which employed:
8. BIRTHPLACE: Rosetta, Ky
9. NAME OF FATHER: Birl Priest
10. BIRTHPLACE OF FATHER: WestView, Ky
11. MAIDEN NAME OF MOTHER: Fannie Smith
12. BIRTHPLACE OF MOTHER: Rosetta, Ky
13. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) Fannie Priest (mother)
(Address) Rosetta, Ky
14. Filed June 25, 1911
REGISTAR: RO Pennick
MEDICAL CERTIFICATE OF DEATH
15. DATE OF DEATH: June 24, 1911
16. I HEREBY CERTIFY, That I attended deceased from (date): June 24, 1911 to June 24, 1911
That I last saw him/her alive on (date): June 24, 1911
And that death occurred on the date stated above at (time AM/PM): 8PM
THE CAUSE OF DEATH was as follows: 
Lightning
(Duration)
Years:
Months:
Days:
Contributory: lived just 2 hours
Signed (M.D.): EC Harned 
Date: 6/24/1911
Address: Garfield, Ky
17. 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:
18. PLACE OF BURIAL OR REMOVAL: Garfield, Ky
DATE OF BURIAL: June 25, 1911
19. UNDERTAKER: R.O. Pennick
ADDRESS: Custer, Ky

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Copyright.  All rights reserved.
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