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Genealogy Pages for Northern Middle TN

Death Certificate for Jim CLIFTON

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

Place of Death: County: Dickson, Civil Dist. 2, Village or City: (blank)
     Reg. Dist. No. 221, Primary Reg. Dist. No. 2, Reg. No. 63, File No. 63
Full Name: Jim CLIFTON
Sex: M     Race: W     Marital Status: single
Date of Birth: 7/4/1917
Age: 1 mos.
Occupation: (blank)
Birthplace: Tenn. Dickson
Name of Father: Isaac CLIFTON
Birthplace of Father: Tenn.
Maiden Name of Mother: Gertrude LA----              (the rest of last name is illegible)
Birthplace of Mother: Tenn.
Informant: A. J. DONEGAN   Address: Dickson
Filed: 8/5/1917           W. J. Sugg, Registrar
Date of Death:  8/4/1917
Death occurred at: (blank)
Cause of Death: unknown       No Physician
Signed by: (blank)       Date: (blank)      Address: (blank)
Place of Burial: Clifton Cemetery      Date of Burial: 8/4/1917
Undertaker: Taylor Bros. & Davis      Address: Dickson

� 2001 Vanessa Slea