|Following is a transcription of the above
person's (TN) death certificate:
Place of Death: County: Robertson, Civil Dist.: 15, Reg. Dist.: 47515
Village or City: Cross Plains, File No.: 142, Reg. No.: 47515
Full Name: James Mulloy FORD
Sex: Male Race: White Marital Status: Single
Date of Birth: 02/16/1843
Age: 74 yrs. 8 mos. 32 ds.
Birthplace: Cross Plains, Tenn.
Name of Father: James H. FORD
Birthplace of Father: Washington Co. Md
Maiden Name of Mother: Elizabeth PAYNE
Birthplace of Mother: Cross Plains, Tenn.
Informant: Nellie KINNEY Address: Cross Plains, Tenn.
Filed: 11/20/1917 C. K. Howard, Registrar
Date of Death: 11/08/1917
The physician attended him from 07/1917 to 11/08/1917
and last saw him alive on 11/08/1917
Death occurred on date above at 4:45 pm
Cause of Death: Remittant fever Duration: 4 mos.
Signed: J. W. Thomas, M. D. Address: Cross Plains, Tenn.
Place of Burial: Payne Cemetery Date of Burial: 11/09/1917
Undertaker: Springfield Fu. Co. Address: Springfield, Tenn.