Death Certificate
of
Allen Green McCollum
Submitted by Adam D. McCartney
STATE OF TENNESSEE
Bureau of Vital Statistics
CERTIFICATE OF DEATH
File No. 450, Registered No. 88
1. Place of Death: Gibson County, Civil District 14
2. Full Name: A. G. McColum
3. Sex: Male
4. Color or Race: White
5. Marital Status: Widowed
6. Date of Birth: 12-28-1845
7. Age: 74 years, 8 months, 18 days
8. Occupation: Farmer
9. Birthplace: Tenn.
10. Name of Father: Abner McColum
11. Birthplace of Father: N. C.
12. Name of Mother: Catherine Mc
13. Birthplace of Mother: N. C.
14. Informant: (Left blank)
15. Filed: 10/6/1920 by M. C. Boone, Registrar
16. Date of Death: 9-16-1920
17. I HEREBY CERTIFY, That I attended deceased from (left blank) to (left blank) and that I last saw him alive on (left blank), and that death occurred on the date stated above at (left blank). The CAUSE OF DEATH was as follows: Tuberculosis. Signed, A.J. Bryant, M.D., Bradford
18. Length of Residence: (Left blank)
19. Place of burial: Bradford
20. Undertaker: M & O (Which would be Meadows and Overton
(Note: Mother’s name was simply written as “Catherine Mc.” I don’t know if they were unaware of her maiden name and the Mc stands for McCollum, or if McCollum was also her maiden name???)