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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.  12270
Registered No: 45 
2.	FULL NAME: BEARD, EMMA LUCY 
PERSONAL AND STATICAL PARTICULARS
3.	SEX:  FEMALE
4.	COLOR OR RACE:  BLACK
5.	SINGLE, MARRIED, WIDOWED, OR DIVORCED:  WIDOWED
6.	DATE OF BIRTH:  NOV. 21, 1879
7.	AGE  (yr. mo. da) (If less than 1 day, hours or min?):  33 YR 5 MO 24 DA
8.	OCCUPATION (a.) Trade, profession or particular kind of work:  HOUSEWIFE
(b.)  General nature of industry business or establishment which employed:  
9. BIRTHPLACE:  BRECKINRIDGE CO., KY
10. 	NAME OF FATHER:  CHARLES BURKE
10. BIRTHPLACE OF FATHER:  BRECKINRIDGE CO., KY 
11. MAIDEN NAME OF MOTHER:  SALLIE BEARD
12. BIRTHPLACE OF MOTHER:  BRECKINRIDGE CO., KY 
13. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
(Informant) SALLIE DEJARNET 
(Address)  KINGSWOOD, KY
15.	Filed  MAY 16, 1913
REGISTAR:  D. W. HENRY
MEDICAL CERTIFICATE OF DEATH
16.	DATE OF DEATH:  MAY 15, 1913
17.	I HEREBY CERTIFY, That I attended deceased from (date):  MARCH 6, 1913
That I last saw him/her alive on (date):  MAY 14, 1913
And that death occurred on the date stated above at (time AM/PM):  10 PM
THE CAUSE OF DEATH was as follows:  INTESTINAL TUBERCULOSIS

(Duration)   Years:   5         Months:            Days:  
Contributory:  

(Duration)   Years:            Months:            Days:  
Signed (M.D.):  P. H. NEVITT
Date:  MAY 16, 1913
Address:  IRVINGTON, 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: BEARD BURYING GROUND 
DATE OF BURIAL:  MAY 17, 1913
20.	UNDERTAKER:  G. T. MARSHALL & SON
ADDRESS:  IRVINGTON, KY


ADDITIONAL COMMENTS/NOTES:




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