STATE OF TENNESSEE
State Board of Health
Bureau of Vital Statistics
CERTIFICATE OF DEATH
(Marshall County #667)
PLACE
OF DEATH:
Belfast 5th Civil
District, Marshall County, Tenn.
DATE
OF DEATH: 9 Dec
1917
FULL
NAME:
James Burgess Endsley
SEX: Male
COLOR
OR RACE: White
MARITAL
STATUS:
Married? Yes
DATE
OF BIRTH: ___Oct
1836
AGE
AT DATE OF DEATH: 81 years, 10
months
OCCUPATION: Farmer
BUSINESS Farming
NAME
OF FATHER: Milton
Endsley Father's birth
place: Tenn.
MAIDEN
NAME OF MOTHER: Christine Burgess Mother's birth place: Tenn.
INFORMANT: Mrs. C. A.
Davis Petersburg, Tenn.
SIGNED:
(Indecipherable doctor's handwriting), M. D.
BURIAL
DATE: 10
Dec 1917
BURIAL
PLACE: Round Hill
UNDERTAKER: Higgins Bros
& [not legible], Petersburg, Tenn.
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