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.
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