Death Certificate of Alexander Bolton 1912

Transcription & photocopy Submitted by Mitzi Freeman March 27, 2002
e-mail address: SETraveler@tngenes.net

Certificate of Death
Certificate: 31350
Place of Death: Laurel
Vot Precinct: Independence
City:
Full Name: Alexander C. Bolton
Sex: Male
Color Race: White
Single, Married, Widowed, or Divorced: Married
Date of Birth: May 29, 1836
Age: 76 yrs 6 mos 17 ds
Occupation: Farmer
Birth Place: Tenn
Name of Father: Thomas Bolton
Birth Place of Father: Via
Maiden Name of Mother: Elizabeth James
Birth Place of Mother: North Carolina
Informant: Mane Green
Address: ????
Filed: Dec 17, 191
Registrar: G. J. Karr
Date of Death: Dec 16, 1912
I hereby certify that I attended deceased from Sept 10, 1912 to Dec 10, 1912
that I saw him alive on Dec 10, 1912 and that death occurred, on the date
stated above, at .
The cause of death was as follows: Paralisis and Dropsy of the heart
Contributory:
Signed: Jessie Hix MD
Address: Bunch
Dec 17, 1912
Place of Burial or Removal: Bolton Cemetery
Date of Burial: Dec 17, 1912
Undertaker: John Clark
Address: Vox

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