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m. Bef 1897
Facts and Events
KENTUCKY DEATH CERTIFICATE State file number: 21152 Registrar's number: 46 Registration district: 50 Primary registration district: 4081 1. Place of death a. County: Bath b. City or town: Rural Owingsville c. Name of hospital or institution: nothing listed d. Length of stay in hospital or community: nothing listed 2. Usual residence a. State: Kentucky b. County: Bath c. City or town: Rural Owingsville d. Street number: rural e. If foreign born how long in USA: nothing listed 3. Full name: Everett Warner 4. Sex: male 5. Color of race: white 6a. Single, widowed, married or divorced: divorced 6b. Name of husband or wife: nothing listed 6c. Age of husband or wife if alive: nothing listed 7. Birth date of deceased: June 2, 1898 8. Age 49 years 6 months 2 days 9. Birthplace: Kentucky 10. Usual occupation: farmer 11. Industry or business: nothing listed 12. Father: John Warner 13. Birthplace of father: Kentucky 14. Maiden name of Mother: Ruth Ginter (that is his step mom) 15. Birthplace of mother: Kentucky 16. Informants own signature: John Warner of Owingsville, Kentucky 17. Burial: Warner Graveyard June 16, 1947 18. Funeral director: Barnes & Reynolds of Owingsville, Kentucky 19a. Date received by local registrar: June 27, 1947 19b. Registrar: Mrs. Pearl Broct (best guess on last name) 20. Date of death: June 14, 1947 21. I hereby certify that I attended the deceased from July 10, 1946 to June 14, 1947 and that I last saw him alive on June 13, 1947 and that the death occurred on the date stated above at 5:30 AM. Immediate cause of death: carcinoma of bladder. 22. If death was due to external causes, fill in the following: nothing listed 23. Signed: D. C. Dotson MD of Owingsville, Kentucky 6-10-1947 References
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