************************************************************************
Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/ky/kyfiles.html
************************************************************************
1. PLACE OF DEATH
County:  Breckinridge
Vot. Pol.:  5305
Inc Town:  
City:  Cloverport, KY
No.  
St.  
Ward:  1st 
Registration District No.:  131
Primary Registration District No:  
File No.  6177
Registered No:  54
2. FULL NAME:  Robt L. Spotman
PERSONAL AND STATICAL PARTICULARS
3. SEX:  male
4. COLOR OR RACE:  colored
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  child
6. DATE OF BIRTH:  May 31, 1909
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  2 years, 9 months, 8 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  child
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Cloverport, Breckinridge Co., KY
10. NAME OF FATHER:  Jeff Satterfield
11. BIRTHPLACE OF FATHER:  Cloverport, KY
12. MAIDEN NAME OF MOTHER:  Jessie Spotman
13. BIRTHPLACE OF MOTHER:  Cloverport, KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Jeff Satterfield
(Address)  Cloverport, KY
15. Filed  Mar 9, 1912
REGISTAR:  J C Nolte
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  March 8, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  March 7th 1912 to March 8th 1912
That I last saw him/her alive on (date):  March 7th, 1912
And that death occurred on the date stated above at (time AM/PM):  
THE CAUSE OF DEATH was as follows:  Congestion of the Brain

(Duration)   Years:            Months:            Days:  1
Contributory:  Very Nervous Child

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  F. L. Lightfoot
Date:  March 9, 1912
Address:  Cloverport, 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:  Cloverport, KY
DATE OF BURIAL:  March 9, 1912
20. UNDERTAKER:  M. Hamman & Son
ADDRESS:  Cloverport, KY


ADDITIONAL COMMENTS/NOTES:




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

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

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

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