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Hardeman County Tennessee

Dewancie Deming:                 

Certificate of Death
Dept. of Public Health State of Tennessee
Cooperating with Dept. of Commerce  Div. of Vital Statistics

Registered Number: 551
Registration District Number: 351

1. Full name: Dewancie Deming
2. Date of Death: Dec. 19, 1939

3 Place of Death
a) County: Hardeman Civil District: 7
b) City or Town: Rt. 2 Hornsby
c) Name of Hospital:
d) Length of stay in Hospital: In community:

4. Legal residence
a) State: Tenn
b) County: Hardeman Civil District: 7
c) City or town: Rt. 2 Hornsby
d) Street No:
e) If Foreign Born How Long In U.S.A.:

5. Race or Color: White
6. Sex: Female
7. Single, Married, Widowed, Divorced: Widowed
8. Age: 81 years
9. Date of birth: Month: Dec Day: Not Known Year: 1858
10. Place of birth: City or County: State: Tenn
11. Husband or Wife of: W. T. Deming
Age of husband or wife, if living:
12. If veteran name of war:
Social Security Number:
13. Usual occupation: Housekeeper
14. Industry or business:
15. Father: Full Name: Grover Rook
Birthplace: Tenn.
16. Mother: Full Name: Biddie Huddleston
Birthplace: Not Known
17. Informant: G C Deming
Address: Hornsby
18. Burial, Removal or Cremation: Burial Date: Dec. 20, 1939
Cemetery: Wesley Place: Hardeman Co.
19: Undertaker: R. P. Shackelford
Address: Bolivar By: M. L. G.

Medical Certification
20. I hereby Certify, that I attended the deceased from
Dec 17 1939 to Dec 19, 1939
and that i last saw her alive on Dec 19, 1939, and that death occurred on
the date stated at 9:00 PM.

Immediate Cause of death:
Ulcers of Lung

Due To: T.B.

Signature: W. H. Siler, M.D.
Address: Silerton, Tenn Date signed:

Date Filed: Jan 2, 1940 Mrs. L. PruittRegistrar

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