PERSONAL AND STATISTICAL PARTICULARS
1. Place of death: County: Taylor, Voting precinct: S. Elkhorn
2. Full name: Elizabeth Mings
3. Sex: Female
4. Color or race: White
5. Single, married, widowed, or divorced: Married
6. Date of birth: Mar. 1, 1855
7. Age: 63 yrs., 9 mos.
8. Occupation: Housewife
9. Birthplace: Kentucky
12. Name of father: Thomas Cox
13. Birthplace: Ky.
14. Maiden name of mother: Jane McD????
15. Birthplace of mother: Kentucky
16. The above is true to the best of my knowledge: [Informant] Jim Mings

MEDICAL CERTIFICATE OF DEATH
20. Date of death: Dec. 1, 1918
21. I did not attend deceased. No physician did. I secured this information from family and that death occurred on the date stated above at 9 pm.
The cause of death was as follows: Chronic bronchitis