************************************************************************ 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.: 5307 Inc Town: City: Cloverport, Ky No. St. Ward: 3 Registration District No.: 131 Primary Registration District No: File No. 17898 Registered No: 115 2. FULL NAME: Morgan Tabeling PERSONAL AND STATICAL PARTICULARS 3. SEX: Male 4. COLOR OR RACE: White 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: Single 6. DATE OF BIRTH: April 1st, 1913 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 3 mos 10 ds 8. OCCUPATION (a.) Trade, profession or particular kind of work: none (b.) General nature of industry business or establishment which employed: none 9. BIRTHPLACE: Kentucky 10. NAME OF FATHER: Albert Tabeling 11. BIRTHPLACE OF FATHER: Kentucky 12. MAIDEN NAME OF MOTHER: Lillie Pate 13. BIRTHPLACE OF MOTHER: Kentucky 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) Albert Tabeling (Address) Cloverport, Ky 15. Filed July 10, 1913 REGISTAR: J. C. Nolte MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: July 10, 1913 17. I HEREBY CERTIFY, That I attended deceased from (date): July 3, 1913 to July 9, 1913 That I last saw him/her alive on (date): July 6, 1913 And that death occurred on the date stated above at (time AM/PM): 1 a.m. THE CAUSE OF DEATH was as follows: Cholera Infantum (Duration) Years: Months: Days: Contributory: (Duration) Years: Months: Days: Signed (M.D.): J. T Owens, M.D. Date: July 19, 1913 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: Tarfork, Ky DATE OF BURIAL: July 10, 1913 20. UNDERTAKER: M. Hamman Sons 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 ************************************************************************