Following is a transcription of the above person's (TN) death certificate:
Place of Death: County: Dickson, Civil Dist. 9, Village or City: (blank)
Reg. Dist. No. 224, Primary Reg. Dist. No. 42209, Reg. No. 13, File No. (blank)
Full Name: Mary Jane ELLIS
Sex: Female Race: white Marital Status: married
Date of Birth: 4/2/1845
Age: 72 yrs. 3 mos. 17 ds.
Name of Father: (blank)
Birthplace of Father: (blank)
Maiden Name of Mother: Cinthy JOURDEN
Birthplace of Mother: Tenn.
Informant: Mrs. Missouri POTTS Address: Slayden Tenn.
Filed: 8/20/1917 J. C. Geurin, Registrar
Date of Death: 8/19/1917
The physician attended her from Feb. 1917 to 8/19/1917
and last saw her alive on 8/18/1917
Death occurred at: 4:49? AM
Cause of Death: Advanced Arteriosclerosis Contributory: Cardiac Insufficiency
Signed by: J. C. Geurin, M. D. Date: 8/19/1917 Address: Slayden Tenn.
Place of Burial: Jourden Cemetery Date of Burial: 8/20/1917
Undertaker: H. E.? Allen Address: Slayden Tenn.
© 2001 Vanessa Slea