|Following is a transcription of the above
person's (TN) death certificate:
Place of Death: County: Robertson, Civil Dist.: 11, Reg. Dist.: 47411?, Reg. No.: 40
Full Name: Jane BLACKMORE?
Sex: Female Race: Col. Marital Status: married
Date of Birth: 11/18/1852
Age: 64 yrs. 1 mos. 12 ds.
Occupation: House keeping
Name of Father: (blank)
Birthplace of Father: (blank)
Maiden Name of Mother: (blank)
Birthplace of Mother: (blank)
Filed: 2/1917 <no day given> H. B. Wilkinson, Registrar
Date of Death: 01/19/1917
The physician attended deceased from 12/10/1916? to Jan. 1917
and last saw her alive on Jan. 1917
Death occurred on date stated above at: 8 AM
Cause of Death: Tuberculosis of lungs Duration: 6 mos.
Signed: R. O. Barry <no date given> Address: White House, Tenn.
Place of Burial or Removal: Estes Cem. Date of Burial: 01/20/1917
Undertaker: H. B. Wilkinson Address: White House