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1. PLACE OF DEATH
County:  Breckenridge 
Vot. Pol.:  Hardinsburg
Inc Town:  Hardinsburg
City:  
No.  
St.  
Ward:  3
Registration District No.:  130
Primary Registration District No:  5303
File No.  572
Registered No:  [unreadable]
2. FULL NAME:  Mary Francis Sheeran
PERSONAL AND STATICAL PARTICULARS
3. SEX:  female
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  single
6. DATE OF BIRTH:  March 24, 1906
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  4 years, 9 months, 18 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  at home
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Kentucky
10. NAME OF FATHER:  Nicholas Sheeran
11. BIRTHPLACE OF FATHER:  Kentucky
12. MAIDEN NAME OF MOTHER:  Marcella Burch
13. BIRTHPLACE OF MOTHER:  Kentucky
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Mrs. Marcella Sherran
(Address)  Hardinsburg
15. Filed  Jan 2, 1913
REGISTAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Jan 1, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  Jan 7 to Jan 11, 1913
That I last saw him/her alive on (date):  Jan 11, 1913
And that death occurred on the date stated above at (time AM/PM):  10:45 PM
THE CAUSE OF DEATH was as follows:  Acute Inflammation of Lungs
 
(Duration)   Years:            Months:            Days:  
Contributory:  Pneumonia
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  Jno. E. Kincheloe
Date:  Jan 11, 1913
Address:  Hardinsburg, 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:  St Romuald Cemetery
DATE OF BURIAL:  Jan 14, 1913
20. UNDERTAKER:  Jon. T. Hoben
ADDRESS:  Hardinsburg, Ky
 

ADDITIONAL COMMENTS/NOTES: The number '3831' written in at the top right hand side of the certificate.  The dates for attended, death,and burial are in conflict with each other.  Cemetery books for the county do not reflect a name by which further info would clear up conflict.

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