************************************************************************
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.:  12
Inc Town:  IRVINGTON
City:  
No.  
St.  
Ward:  
Registration District No.:  
Primary Registration District No:  5312
File No.  17470
Registered No: 5312 
2.	FULL NAME:  THOMPSON, EUGENE
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  MALE
4.	COLOR OR RACE:  NEGRO
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  SINGLE
6.	DATE OF BIRTH:  SEP 1, 1896
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  18 / 11 / 2
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  LABORER	
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  KENTUCKY
10.	NAME OF FATHER:  GEORGE THOMPSON
11.	BIRTHPLACE OF FATHER:  KENTUCKY
12.	MAIDEN NAME OF MOTHER:  NANCY BOARD
13.	BIRTHPLACE OF MOTHER:  NOT LISTED
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  LOUIS BOARD
(Address)  IRVINGTON
15.	Filed  JUN 30, 1914
REGISTAR:  D.W. HENRY
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  JUL 3, 1914
17.	I HEREBY CERTIFY, That I attended deceased from (date):  APR 1, 1914 TO JUL 3, 1914
That I last saw him/her alive on (date):  JUL 1, 1914
And that death occurred on the date stated above at (time AM/PM):  5 AM
THE CAUSE OF DEATH was as follows:  INTERSTITIAL TUBERCULOSIS
(Duration)   Years:            Months:     4       Days:    
Contributory:  
(Duration)   Years:            Months:            Days:  
Signed (M.D.):  P.H. NEVITT
Date:  JUL 3, 1914
Address:  IRVINGTON
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:  OAK GROVE
DATE OF BURIAL:  JUL 4, 1914
20.	UNDERTAKER:  G.T. MARSHALL & SONS
ADDRESS:  IRVINGTON


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

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