|Following is a transcription of the above
person's (TN) death certificate:
Place of Death: County: Robertson, Civil Dist.: 9, Primary Reg. Dist.: 27509
Village or City: Springfield, Reg. Dist.: 752, Reg. No. 478
Full Name: John Yates BLOODWORTH
Sex: M Race: Wh Marital Status: widowed
Date of Birth: 05/27/1859
Age: 58 yrs. 3 mos. 27 ds.
Occupation: Farmer Nature of Industry: Merchant
Name of Father: Thimothy BLOODWORTH
Birthplace of Father: Tenn.
Maiden Name of Mother: Mary Elizabeth STRAIGHTER
Birthplace of Mother: Tenn.
Informant: Mrs. James EIDSON Address: Springfield, Tenn.
Filed: 09/20/1917 Frank Bell, Registrar
Date of Death: 09/19/1917
The physician attended him from 06/01/1917 to 09/1917
and last saw him alive on 09/1917
Cause of Death: Mitral Regurgitation
Signed: W. B. Dye, M. D. Date: 09/20/1917 Address: Springfield, Tenn.
Place of Burial: Elmwood Cem. Date of Burial: 09/20/1917
Undertaker: Henry & Bell Address: Springfield, Tenn.