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Genealogy Pages for Northern Middle TN

Death Certificate for Gladis CLARK

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Following is a transcription of the above person's (TN) death certificate:

Place of Death: County: Dickson, Civil Dist. 8, Village or City: Cumb Fce Tenn.
     Reg. Dist. No. 42208, Primary Reg. Dist. No. 42208, Reg. No. 20, File No. (blank)
Full Name: Gladis CLARK
Sex: Female     Race: White     Marital Status: Single
Date of Birth: 9/7/1915
Age: 1 yrs. 11 mos. 2 ds.
Occupation: (blank)
Birthplace: Cumberland Furnace
Name of Father: Charlie CLARK
Birthplace of Father: Tenn.
Maiden Name of Mother: Ada POOL
Birthplace of Mother: Tenn.
Informant: Charlie CLARK   Address: Cumberland Fce Tenn
Filed: 8/9/1917           W. M. Cunningham, Registrar
Date of Death:  8/9/1917
The physician attended her from 8/6/1917 to 8/9/1917
     and last saw her alive on 8/8/1917
Death occurred at: 7:30 PM
Cause of Death: Inanition             Duration: 12 mos.
     Contributory: Gastro-enteritis              Duration: 14 ds.
Signed by: L. F. Loggins, M. D.       Date: 8/9/1917      Address: Stayton Tenn.
Place of Burial: Cumb Fce Church?      Date of Burial: 8/10/1917
Undertaker: Charlie Clark      Address: Cumb Fce Tenn

� 2001 Vanessa Slea