Death Certificate Information: Charley Nichols, Smith County, Texas

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28 October 2001
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TEXAS DEPARTMENT OF HEALTH
BUREAU OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
5342

1. PLACE OF DEATH STATE OF TEXAS
COUNTY OF: Smith
City of Precinct: Winona Route #1
Full name of desceased: Charlie A. Nichols
Length of residence: 69 years
Social Security No.: none
Residence of the desceased: Route #2 Winona, Smith, Texas

PERSONAL AND STATISTICAL PARTICULARS
Sex: Male
Color or race: white
Single or married: married
Date of Birth April 25, 1866
Age 77 years 8 months 21 days
Trade or profession: Farmer
Birthplace: Crawford County, Georgia
Father's name: D. B. Nichols
Birthplace: Georgia
Maiden name of mother: Mary Gregory
Birthplace: Georgia
Signature: Mrs. C. A. Nichols (wife)
Place of burial: Nichols Family cemetery
Date of death: Jan 15, 1944
The primary cause of death was:
Acute Dilation Heart Accute  Oedemia Lungs
Contributory: senility chronic
myocarditas
doctor's signature unreadble.