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Following is a transcription of the above person's (TN) death certificate:
Place of Death: Dickson County, Civil Dist. 6, Registration Dist. No. 223,
Primary Registration Dist. No. 6, Reg. No. 3
Full Name: Mary T. STORY
Sex: Female Race: white Marital Status:
widowed
Date of Birth: June, 1839
Age: 77 yrs. 7 mos.
Occupation: Housewife
Birthplace: Ky.
Name of Father: Fa?gh?? (Faughon ?)
Birthplace of Father: Ky.
Maiden Name of Mother: Miss Cotton
Birthplace of Mother: Virginia
Informant: W. M. STORY Address:
Vanleer Tenn.
Filed: Jan. 28, 1917
H. E. Larkins,
Registrar
Date of Death: Jan. 27, 1917
The physician last saw her alive on 1/27/1917
Death occurred at 8 PM
Cause of Death: Acute Dilatation of Heart
Signed W. A. Bell, M. D. 1/27/1917
Address: Cloverdale Tenn.
Place of Burial: Story Grave Yard
Date of Burial: 1/28/1917
Undertaker: W. T. McGee
Address: Vanleer
Tenn.