Genealogy Pages for Northern Middle TN
Death Certificate for Chas. B. PAYNE
| Following is a transcription of the above
person's (TN) death certificate: Place of Death: County: Robertson, Civil Dist.: 1st, Reg. Dist.: 47501 Reg. No.: 50 Full Name: Chas. B. PAYNE Sex: Male Race: White Marital Status: Married Date of Birth: 09/27/1861 Age: 56 yrs. 2 mos. 16 ds. Occupation: Farmer Birthplace: Tenn. Name of Father: Larkin C. PAYNE Birthplace of Father: Tenn. Maiden Name of Mother: Susan ARNOLD Birthplace of Mother: Tenn. Informant: Mrs. Nora PAYNE Address: Orlinda, Tenn. Filed: 12/04/1917 W. B. Jernigan, Registrar Date of Death: 12/13/1917 The physician attended him from 06/1917 to 12/1917 and last saw him alive on 12/05/1917 Death occurred on date above at 12 pm Cause of Death: Rectal carcinoma Signed: G. R. Jones, M. D. Date: 12/14/1917 Address: Orlinda, Tenn. Place of Burial: Pleasant Hill Date of Burial: 12/14/1917 Undertaker: J. A. Crocker & Son Address: Orlinda, Tenn. |