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Following is a transcription of the above person's (TN) death certificate:
Place of Death: Montgomery County, Civil Dist. 9, Registration District No. 46409,
Primary Registration District No. 46409, Registered No. 4
Full Name: Wm. Henry Merriwether
Sex: Male Race: Negro (Marital Status):
Married
Date of Birth: (blank)
Age (at death): 29 yrs.
Occupation: Carpenter Helper
Birthplace: Tennessee
Name of Father: Wm. Merriwether
Birthplace of Father: Tennessee
Maiden Name of Mother: Mary Ourban(?)
Birthplace of Mother: Tennessee
Informant: Lee Gilmore Address: Carbondale ????
Date of Death: April 13, 1916
Cause of Death: No medical attendant
Length of residence at place of death: 29 yrs.
Place of Burial: Pleasant Hill Cemetery
Date of Burial: April 14, 1916
Undertaker: Wm. H. Kusee(?) Address: Clarksville