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Genealogy Pages for Northern Middle TN

Death Certificate for Myrtle JACOBS

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

Place of Death: Robertson County, Civil District: 7th, Primary Registration District No. 47507
     File No. 31
Full Name: Myrtle JACOBS
Sex: Female     Race: White     (Marital Status): Single
Date of Birth: Aug. 10, 1914
Age: 1 yrs. 11 mos. 1 ds.
Occuption: Infant
Birthplace: Tenn.
Name of Father: Ewing Jacobs
Birthplace of Father: Tenn.
Maiden Name of Mother: Ida Elliott
Birthplace of Mother: Tenn.
Informant: Carrell Jackson        Address: Cedar Hill R#5
Filed: July 11, 1916          M. A. Ro??ter, Registrar
Date of Death: July 11, 1916
The physician attended her from July 7, 1916 to July 11, 1916
     and last saw her alive on July 11, 1916
Death occurred at 8 am
Cause of Death: Cholera Infantum(?)
Signed D. T.(?) Gardner, M. D.
July 11, 1916        Address: Adams Tenn R#1
Place of Burial or Removal: Jacob Place          Date of Burial: July 11, 1916
Undertaker: Henry(?) and Bell            Address: Springfield

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