1. Name MAHALA BRAY WILLIAMSON
2. Date of death May 31, 1950
3. Color or race WHITE
4. Sex FEMALE
5. Single, married, widowed, divorced
Widowed
6. Date of birth Sept. 10 1870
7. Age (in years last birthday) 79
8. Place of death A. County KNOX
B. Civil District C. KNOXVILLE D. Length of stay in this place
E. Name of hospital or institution (if not Hospital or Institution, City
Street Address and Location) 129 W. ATLANTIC AVE.
9. Usual residence of deceased A.
State TENN. B. County KNOX C. Civil District
D. City or Town KNOXVILLE E. Street address 129 W. ATLANTIC
AVE.
10a. Usual occupation HOUSEWORK
10b. Kind of business or industry
AT HOME
11. Social Security Number
12. Was deceased ever in U.S. armed forces?
Specify yes, no, unknown NO
13. Birthplace TENN.
14. Citizen of what country? U.S.
15. Father's name JOSEPH BRAY
16. Mother's maiden name SALINA MOORE
17. Informant W.R. WILLIAMSON, KNOXVILLE,
TENN.
18. Cause of death 1. Disease or condition
directly leading to death (A) CORONARY ACCLUSION due to (B)
ARTERIOSCLEROTIC MYCARDIATIS due to (C) HYPERTENSIVE CARDIOVASCULAR
HAYDRATHORAXON
19a. Date of operation
19b. Major findings of operation
20a. Autopsy NO
20b. Findings of autopsy
21a. Accident suicide homicide (specify)
21b. Plac of injury
21c. Place of injury
21d. Time of injury
21e. Injury occurred
21f. How did injury occur?
22. I hereby certify that the ceceased died
on the date and from the cause stated above C. E. IRWIN, M.D.,
KNOXVILLE, TENN. 6 JUNE 50
23a. Burial, cremation, removal (specify)
BURIAL
23b. Date of burial, cremation, or removal
JUNE 2, 1950
23c. Name of cemetery or crematory
LENOIR CITY
23d. Location LENOIR CITY, TENN.
24. Funeral Director ROSE FUNERAL HOME,
KNOXVILLE, TENN.
25. Registration Dist. no 24701
26. Date signed by Local Reg. JUNE
7, 1950
27. Registrar's signature MARY CHAMBERS