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1.	PLACE OF DEATH
County:  BRECKINRIDGE
Vot. Pol.:  HARDINSBURG
Inc Town:  
City:  
No.  
St.  
Ward:  
Registration District No.:  130
Primary Registration District No:  5302
File No.  571
Registered No:  143
2.	FULL NAME: WARFIELD, JESSEE J.  
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  BLACK
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  MARRIED
6.	DATE OF BIRTH:  DEC 8, 1888
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  29 / 1 / 5
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  HOUSEKEEPER
(b.)  General nature of industry business or establishment which employed:  
9.	BIRTHPLACE:  BRECKINRIDGE COUNTY
10.	NAME OF FATHER:  BENJAMIN GUTHRY
11.	BIRTHPLACE OF FATHER:  BRECKINRIDGE
12.	MAIDEN NAME OF MOTHER:  MARY ELLEN PARKER
13.	BIRTHPLACE OF MOTHER:  BRECKINRIDGE
14.	THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  BENJAMIN GUTHRY
(Address)  HARDINSBURG
15.	Filed  JAN 14, 1913
REGISTAR:  W.B. LENNON
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  JAN 13, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  JAN 1, 1913 to JAN 13, 1913
That I last saw him/her alive on (date):  JAN 2, 1913
And that death occurred on the date stated above at (time AM/PM):  6 AM
THE CAUSE OF DEATH was as follows:  PLEURISY & DISEASE OF THE LUNGS & BRONCHITIS
(Duration)   Years:      1      Months:    1        Days:    
Contributory:  SUPPRESSION MUCOUS

(Duration)   Years:    1        Months:    1        Days:  
Signed (M.D.):  JAMES C. SUTTON
Date:  JAN 13, 1913
Address:  
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:  COLORED CEMETERY
DATE OF BURIAL:  JAN 14, 1913
20.	UNDERTAKER:  B.F. BEARD
ADDRESS:  HARDINSBURG


ADDITIONAL COMMENTS/NOTES:




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Dana Brown http://www.genrecords.net/emailregistry/vols/00005.html#0001067
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