Following is a transcription of the above person's (TN) death certificate:
Place of Death: County: Dickson, Civil Dist. 8, Village or City: Cumb Fce Tenn.
Reg. Dist. No. 42208, Primary Reg. Dist. No. 42208, Reg. No. 20, File No. (blank)
Full Name: Gladis CLARK
Sex: Female Race: White Marital Status: Single
Date of Birth: 9/7/1915
Age: 1 yrs. 11 mos. 2 ds.
Birthplace: Cumberland Furnace
Name of Father: Charlie CLARK
Birthplace of Father: Tenn.
Maiden Name of Mother: Ada POOL
Birthplace of Mother: Tenn.
Informant: Charlie CLARK Address: Cumberland Fce Tenn
Filed: 8/9/1917 W. M. Cunningham, Registrar
Date of Death: 8/9/1917
The physician attended her from 8/6/1917 to 8/9/1917
and last saw her alive on 8/8/1917
Death occurred at: 7:30 PM
Cause of Death: Inanition Duration: 12 mos.
Contributory: Gastro-enteritis Duration: 14 ds.
Signed by: L. F. Loggins, M. D. Date: 8/9/1917 Address: Stayton Tenn.
Place of Burial: Cumb Fce Church? Date of Burial: 8/10/1917
Undertaker: Charlie Clark Address: Cumb Fce Tenn
© 2001 Vanessa Slea