Burke County, NC - Vitals - Spicy Emaline Cook Childers, 1917

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Death Certificate for Spicy Emaline Cook Childers

North Carolina State Board of Health        
Bureau of Vital Statistics
Certificate of Death    
Registration District No.  12-5140   
Certificate No. 8

1. Place of Death
County    Burke
Township  Icard
2. Full Name   Spicy Emaline Childers
PERSONAL AND STATISTICAL PARTICULARS
3. Male or Female   Female
4. Color or Race    White
5. Single, Married, Widowed or Divorced    Married
6. Date of Birth    Feb   8,  1839
7. Age  77 years  10 mos.  27 ds.
9. Birthplace   Burke Co.
PARENTS
10. Name of Father    Jessie Cook
11. Birthplace of Father   Cleveland Co.
12. Name of Mother before Marriage   Martha Aiken
13. Birthplace of Mother    Burke Co.
14. The above is true to the best of my knowledge  
(Informant)  C.A. Childers   (Address)   Connelly Springs
15. Filed  Feb 9, 1917     G.L. Stine B.C.  Registrar
16. Date of Death   Jan 5th  1917
17. I HEREBY CERTIFY, that I attended the deceased from  
Apr 21, 1916 to Nov 12th, 1916 that I last saw her alive on  
Nov 12th, 1916 and that the cause of death occurred on the 
date above stated, at 4pm
The CAUSE OF DEATH was as follows:   
Sarcoma of the calf of left-leg
(Duration)  10 mos.
(Signed)   T.V. Goode, M.D.  Feb 7, 1917  
(Address) Connelly Springs, NC
19. Place of Burial or Removal   Fairview Meth (?)  
Date of Burial     Jan 7, 1917
20. Undertaker   S.U. Wilson   Address  Connelly Springs NC

Certificate number 224 at Burke County Courthouse