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Following is a transcription of the above person's (TN) death certificate:
Place of Death: County: Dickson, Civil Dist. 5, Village or City: Dickson
Reg. Dist. No. 221, Primary Reg. Dist. No. 5
Full Name: Ann PERKINS
Sex: female Race: negro Marital Status:
widow
Date of Birth: Aug. 27, 1849
Age: 68 yrs.
Occupation: House Wife
Birthplace: Dickson County
Name of Father: Cornelious WILSON
Birthplace of Father: (blank)
Maiden Name of Mother: (blank)
Birthplace of Mother: (blank)
Informant: Tom PERKINS Address: Dickson, Tenn.
Filed: 2/3/1917 W. J. Sugg, Registrar
Date of Death: 1/31/1917
The physician attended her from 1/29/1917 to 1/29/1917
and last saw her alive on 1/29/1917
Death occurred at: 5AM
Cause of Death: Lobar Pneumonia Duration: 2 wks.
Contributory: exposure
Signed by: N. Miles, M. D. Date: 1/31/1917
Address: Dickson, Tenn.
Place of Burial: Dickson Date of Burial:
2/1/1917
Undertaker: (blank) Address: (blank)
� 2001 Vanessa Slea