************************************************************************ 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 No. St. Ward: 1st Registration District No.: 131 Primary Registration District No: 5305 File No. 17462 Registered No: 159 2. FULL NAME: WALKER, MARTHA J. BRICKEY PERSONAL AND STATICAL PARTICULARS 3. SEX: FEMALE 4. COLOR OR RACE: WHITE 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED: MARRIED 6. DATE OF BIRTH: DEC 8, 1844 7. AGE (yr. mo. da) (If less than 1 day, hours or min?): 69 / 6 / 27 8. OCCUPATION (a.) Trade, profession or particular kind of work: HOUSEKEEPER (b.) General nature of industry business or establishment which employed: 9. BIRTHPLACE: KENTUCKY 10. NAME OF FATHER: JAMES BRICKEY 11. BIRTHPLACE OF FATHER: VIRGINIA 12. MAIDEN NAME OF MOTHER: DON'T KNOW 13. BIRTHPLACE OF MOTHER: VIRGINIA 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant) DICK GILLIAN (Address) CLOVERPORT 15. Filed JUL 6, 1914 REGISTAR: J.C. NOLTE MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: JUL 5, 1914 17. I HEREBY CERTIFY, That I attended deceased from (date): JUN 25, 1914 to JUL 5, 1914 That I last saw him/her alive on (date): JUL 4, 1914 And that death occurred on the date stated above at (time AM/PM): 10:20 PM THE CAUSE OF DEATH was as follows: CEREBRAL HEMMORHAGE (Duration) Years: Months: Days: 10 Contributory: ARTERIO SCLEROSIS (Duration) Years: Months: Days: Signed (M.D.): E.C. McDONALD Date: JUL 6, 1914 Address: CLOVERPORT 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: BRICKEY BURYING GROUND DATE OF BURIAL: JUL 6, 1914 20. UNDERTAKER: M. HAMMAN & SONS ADDRESS: CLOVERPORT 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 ************************************************************************