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Hardeman County Tennessee

Joseph J Ervin:

STATE OF TENNESSEE
State Board of Health
Bureau of Vital Statistics
CERTIFICATE OF DEATH

Registration District Number: 351
File Number: 485

1. Place of Death:
County : Hardeman
Civil Dist: No 7
City: Hornsby, Tenn.
2. Full name: Joseph J Ervin
3. Sex: Male
4. Color or Race: White
5. Single, Married, Widowed, or Divorced: Married
6. Date of Birth: May 17, 1844
7. Age: 79 yrs. 9 mos. 23 days.
8. Occupation
a) Trade, profession,
or particular kind of work: Farmer
9. Birthplace: Hardeman
10. Name of Father: James Ervin
11. Birthplace of Father: Davidson
12. Maiden Name of Mother: Sallie Herrinian
13. Birthplace of Mother: Hardeman
14. The above is true to the best of my knowledge
(informant): J L Ervin
(address): Brownsville, Tenn.

15. Filed: 8-12, 1914 G. M. Dorris
Registrar

16. Date of Death: March 10, 1924
17. I hereby certify, that I attended deceased from
Feb 29, 1924 to March 10, 1924,
that I last saw him alive on March 10, 1924,
and that death occurred, on the date stated above, at 11 p.m.

The cause of death was as follows: Influenza

Duration 12 days

(signed) H. M. Milstead, M.D.
March 11, 1924 (address) Hornsby, Tenn

18. Length of Residence (for hospitals, institutions, transients,
or recent residents):
19. Place of Burial or Removal: Date of Burial:
20. Undertaker: Address:

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