|Following is a transcription of the above
person's (TN) death certificate:
Place of Death: County: Robertson, Civil Dist.: 17, Reg. Dist.: 47517
Primary Reg. Dist.: 17, Reg. No.: 4
Full Name: Dary Della BOOTH
Sex: Female Race: Mulatto Marital Status: married
Date of Birth: 08/12/1847
Age: 70 yrs. 5 ds.
Occupation: House wife
Birthplace: Todd Co., Ky
Name of Father: Chas. TERRY
Birthplace of Father: Todd Co., Ky
Maiden Name of Mother: Dary Della TERRY
Birthplace of Mother: Todd Co., Ky
Informant: Edmon BOOTH Address: Adams, Tenn.
Filed: 09/29/1917 Mrs. Bryant Murphey, Registrar
Date of Death: 08/17/1917
The physician attended her from 07/01/1917 to 08/17/1917
and last saw her alive on 08/17/1917
Death occurred on date above at 11 pm
Cause of Death: Valvular disease of heart & Chronic Nephritis
Duration: 12 mos.
Signed: W. T. Young, M. D. Date: 08/17/1917 Address: Allensville, Ky
Place of Burial: Family B. Graves Date of Burial: 08/20/1917
Undertaker: E. W. Robertson & Co. Address: Adams, Tenn.