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Genealogy Pages for Northern Middle TN

Death Certificate for Jordan SMITH

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

Place of Death: County: Dickson, Civil Dist. 6, Village or City: (blank)
     Reg. Dist. No. 223, Primary Reg. Dist. No. 6, Reg. No. 28, File No. (blank)
Full Name: Jordan SMITH
Sex: Male     Race: Negro     Marital Status: widowed
Date of Birth: 1848
Age: 72 yrs.
Occupation: (illegible) laborer         Nature of Industry: mostly farm work
Birthplace: Tenn.
Name of Father: Don't know
Birthplace of Father: Do not know
Maiden Name of Mother: Pegg GORDON
Birthplace of Mother: Tenn.
Informant: Allemont COLL----          Address: Charlotte Tenn.
Filed: 12/3/1917                H. E. Larkins, Registrar
Date of Death:  12/3/1917
The physician attended him from May? 1917 to Dec. 1917
     and last saw him alive on 10/22/1917
Death occurred at: 1 PM
Cause of Death: Brights Disease       Duration: 1 yrs.
     Contributory: Heart disease           Duration: 4 yrs.
Signed by: A. G. Castleman, M. D.       Date: 12/?/1917      Address: Charlotte Tenn.
Place of Burial: Charlotte Tenn.      Date of Burial: 12/4/1917
Undertaker: O. R. Leech      Address: Charlotte

� 2001 Vanessa Slea