1. PLACE OF DEATH
County: Breckinridge
Vot. Pol.:
Inc Town: McQuady
City:
No.
St.
Ward: 1
Registration District No.: 130
Primary Registration District No: 5301
File No. 24208
Registered No: 125
1. FULL NAME: Susan K Taul
PERSONAL AND STATICAL PARTICULARS
2. SEX: female
3. COLOR OR RACE: white
4. SINGLE, MARRIED, WIDOWED, OR DIVORCED: married
5. DATE OF BIRTH: June 8, 1866
6. AGE  (yr. mo. da) (If less than 1 day, hours or min?): 46yrs4mos1day
7. OCCUPATION (a.) Trade, profession or particular kind of work: housekeeper
(b.)  General nature of industry business or establishment which employed: general house work
8. BIRTHPLACE: Breckinridge Co, Ky
9. NAME OF FATHER: Lawrence T Keenan
10. BIRTHPLACE OF FATHER:
11. MAIDEN NAME OF MOTHER: Mary Jane Keenan
12. BIRTHPLACE OF MOTHER:
13. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) unsigned
(Address)
14. Filed Oct 9, 1912
REGISTAR: WB Lennon
MEDICAL CERTIFICATE OF DEATH
15. DATE OF DEATH: Oct 9, 1912
16. I HEREBY CERTIFY, That I attended deceased from (date): Aug 10, 1912 to Oct 1, 1912
That I last saw him/her alive on (date): Oct 1, 1912
And that death occurred on the date stated above at (time AM/PM): 9:45 PM
THE CAUSE OF DEATH was as follows:
Tuberculis (Tuberculosis)
(Duration)
Years:
Months: 4
Days:
Contributory: Pneumonia
Signed (M.D.): J.T. Owen by Nolte
Date: Oct 10, 1912
Address: Cloverport, Ky
17. 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:
18. PLACE OF BURIAL OR REMOVAL: McQuady Cem
DATE OF BURIAL: Oct 9, 1912
19. UNDERTAKER: EF Lyons
ADDRESS: McQuady Ky

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