CUMBERLAND COUNTY, TN - VITALS - Mirah Millican Death Certificate
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STATE OF TENNESSEE
STATE BOARD OF HEALTH
Bureau of Vital Statistics
CERTIFICATE OF DEATH

 1. Place of Death: Tennessee
    County: Cumberland
    Civil Dist.: 1  
    Registration District No. _______
    File No. 342
    Village or city: Ravenscroft #1
    Primary Registration District no. 4
    Registered No.______
    City: _________________

 2. Full Name: MIRAH MILLICAN
 3. Sex: Female
 4. Color or Race: White
 5. Single, married, widowed, or divorced: Widow
 6. Date of Birth: ___________
 7. Age: About 73 years 
 8. Occupation: Housework
    Occ. Farm
 9. Birthplace: Tennessee
10. Name of Father: BENJAMIN CLOUSE
11. Birthplace of Father: Tennessee
12. Maiden name of Mother: SUSAN SUTTLE
13. Birhtplace of Mother: Tennessee
14. The above is true to the best of my knowledge
    Informant: W.J. TREADWAY
    Address: Ravenscroft #1
15. Filed: Nov 3 1924 Ira Presley, Registrar
16. Date of Death: Jany 6 1924
17. I hereby certify that I attended deceased from _____ to ______, 
    that I last saw him alive on _____, and that the death occurred on 
    the date stated above, at 6 pm
    The cause of death was as follows: no doctor - Dropsy and old age
18. Length of Residence (for hospitals, institutions, transients, or 
    recent residents): _______
19. Place of Burial or removal: Smith Chapel Cemetery
    Date of Burial: 1/7, 1924
20. Undertaker: HB Hunter
    Address: Sparta Tenn