Commonwealth of Kentucky Bureau of Vial Statistics Certificate of Death Place of Death: Sharpsburg,Bath Co, Ky Rural Name: Jane Stewart Perry Female, white, widowed. 83 yrs. old Birth Date: 12 May 1860 Date of Death: 28 Nov 1943 Birthplace: Ky Occupation: Housewife Father: John Stewart Birthplace: Ky Mother: Ellen Headrie (?) Birthplace: Ky Informant: Cyrus Perry Address: Sharpsburg, Ky RFD Burial: Bethel Cem., 29 Nov 1943 FuneralDir. Shrout, Piper,Shrout, Owingsville, Ky Cause of death: Congestive heart failure Due to: Chr. myocarditis (?), senility Signed: W. C. Graham, M.D. Cert. # 23589