************************************************************************
Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
************************************************

File contributed for use in USGenWeb Archives by:
Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
http://www.usgwarchives.net

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

1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  ROCKVALE
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  5320
Primary Registration District No:  
File No.  6382
Registered No:  5020
2.	FULL NAME:  RAIMER (STILLBORN)
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  WHITE
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  SINGLE
6.	DATE OF BIRTH:  MARCH 16, 1913
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  STILLBORN
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  ROCKVALE, KY
10.	NAME OF FATHER:  JOHN T. RAIMER
11.	BIRTHPLACE OF FATHER:  BUTLER CO., KY
12.	MAIDEN NAME OF MOTHER:  MARTHA FINLEY
13.	BIRTHPLACE OF MOTHER:  BUTLER CO., KY
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  J. T. RAIMER
(Address)  GLEN DEAN, KY, RFD 1
15.	Filed  MARCH 20, 1913
REGISTRAR:  J. T. MCDONOGH
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  MARCH 16, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  STILLBORN
That I last saw him/her alive on (date):  
And that death occurred on the date stated above at (time AM/PM):  
THE CAUSE OF DEATH was as follows:  STILLBORN

(Duration)   Years:            Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  SARAH F. BROWN (MIDWIFE)
Date:  MARCH 16, 1913
Address:  GLEN DEAN, 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:  ROBINSON BURIAL GROUND
DATE OF BURIAL:  MARCH 16, 1913
20.	UNDERTAKER:  FATHER
ADDRESS:  GLEN DEAN, KY

************************************************************************
Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
************************************************