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1. PLACE OF DEATH
County:  Breckenridge
Vot. Pol.:  Bewelyville
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5315
Primary Registration District No:  
File No.  15015
Registered No:  4
2. FULL NAME:  Herman Lester Priest
PERSONAL AND STATICAL PARTICULARS
3. SEX:  male
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  single
6. DATE OF BIRTH:  June 13, 1912
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  1 year, 8 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  with parents
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Garfield, Breckenridge County, Ky
10. NAME OF FATHER:  Matt M. Priest
11. BIRTHPLACE OF FATHER:  Garfield, Breckenridge County, Ky
12. MAIDEN NAME OF MOTHER:  Rosa Haynes
13. BIRTHPLACE OF MOTHER:  Garfield, Breckenridge County, Ky
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Marion Ross
(Address)  Garfield, Ky
15. Filed  6/24, 1913
REGISTAR:  John Compton
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  June 21, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  June 14 to June 21, 1913
That I last saw him/her alive on (date):  June 21, 1913
And that death occurred on the date stated above at (time AM/PM):  5 PM
THE CAUSE OF DEATH was as follows:  Cholera Infantum
 
(Duration)   Years:            Months:            Days:  
Contributory:  
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  J. A. Sandbach
Date:  June 22, 1913
Address:  Garfield, 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:  {blank]
DATE OF BURIAL:  [blank]
20. UNDERTAKER:  [blank]
ADDRESS:  [blank]
 

ADDITIONAL COMMENTS/NOTES:
Breckenridge County Cemeteries Volume I, page 367 shopws the following:
Priest, Herman; 1912 -1913; son of Matt & Rosa buried at Garfield Cemetery.
 
 

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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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