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Genealogy Pages for Northern Middle TN

Death Certificate for Charlie ADAMS

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Following is a transcription of the above person's (TN) death certificate:

Place of Death: County: Dickson, Civil Dist. 11, Village or City: (blank)
     Reg. Dist. No. 42211, Primary Reg. Dist. No. (blank), Reg. No. (blank), File No. (blank)
Full Name: Charlie ADAMS
Sex: male     Race: white     Marital Status: married
Date of Birth: 6/22/1882
Age: 34 yrs. 10 mos. 2 ds.
Occupation: Farmer
Birthplace: Dickson Co.
Name of Father: W. M. ADAMS
Birthplace of Father: Tenn.
Maiden Name of Mother: Tennessee DANIEL
Birthplace of Mother: Tenn.
Informant: Walter MCCLURKAN    Address: Tennessee City
Filed: 6/6/1917      J. F. Hunt, Registrar
Date of Death: 4/24/1917
The physician attended him from 4/8/1917 to 4/24/1917
     and last saw him alive on 4/24/1917
Death occurred at: 11 AM
Cause of Death: Malarial Fever       Duration: 16 ds.
Signed by: O. N. Moody, M. D.       Date: (blank)       Address: Tennessee City
Place of Burial: Adams Burying Ground      Date of Burial: 4/25/1917
Undertaker: Taylor Bros. & Davis       Address: Dickson

© 2001 Vanessa Slea