Following is a transcription of the above
person's (TN) death certificate: Place of Death: County: Robertson, Civil Dist.: 16, Reg. Dist.: 752 Primary Reg. Dist.: 47516, Reg. No.: 335 Full Name: John Jeff FUQUA Sex: Male Race: White Marital Status: Single Date of Birth: (blank) Age: 51 yrs. 2 mos. 11 ds. Occupation: Farmer Birthplace: Tenn. Name of Father: Levi FUQUA Birthplace of Father: Tenn. Maiden Name of Mother: Cathrine FUQUA Birthplace of Mother: Tenn. Informant: J. L. ABANATH Address: Green brier, #2 Filed: 5/22/1917 Frank Bell, Registrar Date of Death: 5/21/1917 Death occurred on date above at 1 pm. Cause of Death: No Doctor Signed: Frank Bell, Registrar Place of Burial: Mt. Sharon Date of Burial: 5/22/1917 Undertaker: Henry & Bell Address: Springfield, Tenn. |