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Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
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Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
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1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  Hardinsburg
Inc Town:  
City:  
No.  
St.  
Ward:  1
Registration District No.:  5301
Primary Registration District No:  130
File No.  568
Registered No:  
2. FULL NAME:  Ollie Smith
PERSONAL AND STATICAL PARTICULARS
3. SEX:  female
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  married
6. DATE OF BIRTH:  3-13-1881
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  31 years, 10 months, 8 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  house keeping
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Kentucky
10. NAME OF FATHER:  Fran D. Lasly
11. BIRTHPLACE OF FATHER:  Kentucky
12. MAIDEN NAME OF MOTHER:  Barbara E Armes
13. BIRTHPLACE OF MOTHER:  Kentucky
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Fran D. Lasly
(Address)  West View, Ky
15. Filed  Jan 26
REGISTAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Jan 24, 1913
17. I HEREBY CERTIFY, That I attended deceased from (date):  Oct 1912 to Jan 24, 1913
That I last saw him/her alive on (date):  October
And that death occurred on the date stated above at (time AM/PM):  [unreadable]
THE CAUSE OF DEATH was as follows:  Pulmonary Tuberculosis
 
(Duration)   Years:            Months:            Days:  
Contributory:  
 
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  A. M. Kincheloe
Date:  1-26-1913
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:  [unreadable]
DATE OF BURIAL:  Jan 27, 1913
20. UNDERTAKER:  Pete Sheeran Bro. & Co.
ADDRESS:  Kirk, Ky
 

ADDITIONAL COMMENTS/NOTES:
Breckinridge County Cemeteries Volume 1, page 417, show Ollie G. Smith, Same dates, wife of B. D. buried in Moorman Cemetery #2 in Kingswood.
 
 
 
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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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