|Following is a transcription of the above
person's (TN) death certificate:
Place of Death: County: Houston, Civil Dist.: 1, Village or City: McKinnon, Tenn.
Reg. Dist.: 44201, Primary Reg. Dist.: 1, Registered No.: 2
Sex: Man Race: African Marital Status: Widowed
Date of Birth: unknown
Age: 95 yrs. unknown
Name of Father: unknown
Birthplace of Father: unknown
Maiden Name of Mother: unknown
Birthplace of Mother: unknown
Informant: Horace ASKEW Address: McKinnon, Tenn.
Filed: 03/02/1918 A. F. Weaver, Registrar
Date of Death: 12/14/1917
The physician attended deceased from 12/14/1917 to (blank)
and last saw him alive on 12/14/1917
Death occurred on date stated above at: 10 PM
Cause of Death: Old Age Caused by Lagrippe (illegible)
Dr. (illegible) he did not see him only prescribed medicine.
Signed: A. F. Weaver and O. K. Womack, M. D. 02/26/1918
Address: McKinnon, Tenn.
Place of Burial or Removal: McKinnon, Tenn. Date of Burial: 12/15/1917