************************************************************************
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.:  Big Spring
Inc Town:  near Big Spring
City:  
No.  
St.  
Ward:  
Registration District No.:  5314
Primary Registration District No:  14
File No.  11902
Registered No:  5
2. FULL NAME:  Jabe St. Clair
PERSONAL AND STATICAL PARTICULARS
3. SEX:  male
4. COLOR OR RACE:  white
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  married
6. DATE OF BIRTH:  Oct. 11, 1852
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  59 years, 7 months, 12 days
8. OCCUPATION (a.) Trade, profession or particular kind of work:  farmer
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Breckinridge Co., KY
10. NAME OF FATHER:  John St. Clair
11. BIRTHPLACE OF FATHER:  Ohio State
12. MAIDEN NAME OF MOTHER:  Nancy Carter
13. BIRTHPLACE OF MOTHER:  Breckinridge Co., KY
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Thomas Maklort
(Address)  Big Spring, KY
15. Filed  May 25, 1912
REGISTAR:  J. L. Morris
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  May 23, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  April 28, 1912 to May 23, 1912
That I last saw him/her alive on (date):  May 8, 1912
And that death occurred on the date stated above at (time AM/PM):  10 A.M.
THE CAUSE OF DEATH was as follows:  Chronic Interstitial Nephritis
(Duration)   Years:     1       Months:            Days:   25
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  C. B. Witt
Date:  May 23, 1912
Address:  Big Spring, 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 Clair Cemetery
DATE OF BURIAL:  May 24, 1912
20. UNDERTAKER:  Thomas Marlow
ADDRESS:  Big Spring, 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

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