WHITE COUNTY, TN - VITALS - Minnesota Selby Death Certificate
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CERTIFICATE OF DEATH

STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
Division of Vital Statistics

Death No: 49-06684

1. Name: MINNESOTA SELBY
2. Date of Death (month, day, year): 3-2-49
3. Color or Race: W
4. Sex: Female
5. Single, married, widowed, or divorced: Married
6. Date of Birth (month, day, year): 3-7-1882
7. Age (in years last birthday): 66
8. Place of Death:
 County: White
 Civil District: 1
 City or town: Sparta
 Length of stay in this place: 20 yrs.
 Name of Instition or Hospital: ------
9. Usual Residence of Deceased:
 State: Tenn
 County: White
 Civil District: 1
 City or Town: Sparta
 Street Address: -----
10. Usual Occupation: Housewife
11. Social Security Number: -----
12. Was deceased ever in armed forces: No
13. Birthplace: White, Tenn
14. Citizen of What Country?  U.S.A.
15. Father's name: John Milligan
16. Mother's maiden name: Myra Clouse
17. Informant: Nathan Selby
 Address: Sparta, Tenn
18. Cause of Death: Chronic Myocarditis
19. Date of operation: -----
20. Autopsy: -----
21. Accident, Suicide, Homicide: -----
22. I hereby certify that the deceased died on the date and 
  from the cause stated above.
  Signature: J.C Blauburlup M.D.  
  Address: Sparta 10
  Date: 4-1-49
23. Burial, cremation, removal: Burial
 Date of Burial: 3-4-1949
 Name of Cemetery: Board Valley
 Location: White County, Tenn
24. Funeral Director: Hunter Funeral House
 Address: Sparta, Tenn
25. Registrarion Dist. No: 39301
26. Date signed by local Reg: 4-1-49
27. Registrar's signature: Tina B Camp