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.  21632
Registered No:  121
2. FULL NAME:  Sonny Warfield
PERSONAL AND STATICAL PARTICULARS
3. SEX:  Male
4. COLOR OR RACE:  Colored
5. SINGLE, MARRIED, WIDOWED, OR DIVORCED:  
6. DATE OF BIRTH:  Sept. 12, 1910
7. AGE  (yr. mo. da) (If less than 1 day, hours or min?):  2 yrs
8. OCCUPATION (a.) Trade, profession or particular kind of work:  At Home
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  Breckinridge
10. NAME OF FATHER:  Marion Warfield
11. BIRTHPLACE OF FATHER:  Ky
12. MAIDEN NAME OF MOTHER:  Guthrie
13. BIRTHPLACE OF MOTHER:  Ky
14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant)  Marion Warfield
(Address)  Hardinsburg, Ky
15. Filed  Sept 12, 1912
REGISTAR:  W. B. Lennon
MEDICAL CERTIFICATE OF DEATH
16. DATE OF DEATH:  Sept. 12, 1912
17. I HEREBY CERTIFY, That I attended deceased from (date):  Sept. 8, 1912 to 12, 1912
That I last saw him/her alive on (date):  Sept. 8, 1912
And that death occurred on the date stated above at (time AM/PM):  10 a.m.
THE CAUSE OF DEATH was as follows:  Tuberculosis

(Duration)   Years:            Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  E. A. Lex, M.D.
Date:  1 of 15, 1912
Address:  Hardinsburg, 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:  Colored Cemetery
DATE OF BURIAL:  Sept. 13, 1912
20. UNDERTAKER:  J. T. Hoben
ADDRESS:  Hardinsburg, Ky