|Following is a transcription of the above
person's (TN) death certificate:
Place of Death: County: Robertson, Civil Dist.: 4th, Reg. Dist.: 47504
File No.: 14
Full Name: Maggie BOURNE
Sex: Female Race: White Marital Status: Married
Date of Birth: 03/27/1882
Age: 35 yrs. 8 mos. 6 ds.
Name of Father: John RUSSELL
Birthplace of Father: Ky
Maiden Name of Mother: Alice MILLER
Birthplace of Mother: Ky
Informant: Martin BOURNE Address: Springfield, Tenn.
Filed: 01/01/1918 R. A. Poor, Registrar
Date of Death: 11/03/1917
The physician attended her from 09/27/1917 to 09/27/1917
and last saw her alive on 09/27/1917
Death occurred on date above at 1:05 pm
Cause of Death: Pellegra
Signed: R. L. Mathews, M. D. Date: 11/05/1917 Address: Spg. Tenn.
Place of Burial: Dripping Springs Date of Burial: 11/04/1917
Undertaker: Springfield Furn. Co. Address: city