DEATH CERTIFICATE

TRANSCRIPTIONS D SURNAMES

County of: Pulaski
Township or road district or village:
Primarydist no.:
Full name: Willie DAWSON
Residence no.:
Gender: Male
Color or race: Black Single, married, widowed or divorced:

If married, widowed or divorced
Husband of (or) wife of:
Date of birth:
Age: years months days
Occupation of deceased: Birthplace:

Name of father: Birthplace of father:
Maiden name of mother:
Birthplace of mother:

Informant:
Address: Filed:
Date of death: No date given
Cause of death: At hand of his Father
Place of Death: Near Pulaski Station
Signed:
Place of burial:
Date of burial:
Undertaker:
Address:

 

County of: Pulaski
Township or road district or village:
Primarydist no.:
Full name: Joseph DODSON
Residence no.:
Gender: Male
Color or race: Brown
Single, married, widowed or divorced:
If married, widowed or divorced
Husband of (or) wife of:
Date of birth:
Age: years months days Occupation of deceased:

Birthplace:
Name of father:
Birthplace of father:
Maiden name of mother:
Birthplace of mother:
Informant:
Address:
Filed: Date of death: None given
Cause of death: Accidental Pistol Wound
Place of Death:
Signed:
Place of burial:
Date of burial:
Undertaker:
Address:

 

 

 


 

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