Fayette County GaArchives Deaths.....Mrs. M. J.  Smith November 16 1932
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File contributed for use in USGenWeb Archives by:
Patricia Griggs Stricklin sstricklin@mindspring.com June 29, 2003, 10:54 am

Certificate of Death                                                                                                                      
Georgia Department of Public Heath                                                                                              
Registered No. 12                                                                                                                                
#415                                                                                                                                                  
(written above typed number was 422)                                                                                                      
Place of Death: Fayette                                                                                                                           
Militia District: Brooks 1293                                                                                                           
State, City or Town: Brooks RFD 1                                                                                                                                 
Non-resident (yes or no): no                                                                                                                                                                                                                         
Full Name: Mrs. M. J. Smith (note: this is Mary Jane (Bowers) who married L. A. Smith)                 
Residence: Brooks RFD                                                                                                                      
State: Ga.                                                                                                                                            
Personal and Statistical Particulars                                                                                                    
Sex: Female                                                                                                                                    
Color: White                                                                                                                             
Single, Married, Widowed, Divorced: Widow                                                                                                              
Age: 75                                                                                                                                               
Trade, Profession, etc: Dosmestic                                                                                                           
Birthplace: Brooks, Ga.                                                                                                                            
Father: Lee Bowers (note: this is Levi Bates Bowers)                                                                    
Birthplace: Ga.                                                                                                                                     
Mother: Delila Ward (note: this is Delilah Jane "Lilley/Lilie" Ward)                                                       
Birthplace: Ga                                                                                                                                
Informant: Sam Cobb                                                                                                                                      
Address: Brooks RFD, Ga.                                                                                                                    
Burial Place: County Line                                                                                                                
Postoffice:  Brooks                                                                                                                  
Date: 11-17-1932                                                                                                                       
Undertaker: Haiston Bros.                                                                                                                             
Address: Senoia, Ga.                                                                                                                      
Medical Certificate of Death                                                                                                         
Date of Death: 11-16, 1932    at 8 p.m.                                                                                                                       
I hereby certify that I attended the deceased from 6 __ 1930 to 11-16-1932                                     
I last saw her alive on 11-16, 1932                                                                                             
The Principal Cause of Death: Tubercular pneumonia                                                                         
Signed: W. F. Culpepper, M.D.                                                                                                  
Address: Senoia, Ga.                                                                                                                       
Filed: Nov. 18, 1932                                                                                                                     
Signed: E. R. Coggins

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