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Hulda Asberine (Asberine) Cross Death Certificate      image of death certificate       image of tombstone

State of Tennessee
State Board of Health
Bureau of Vital Statistics
Certificate of Death
 
1. Place of death -- County: Anderson, Civil Dist.: 9, Registration District: 40109, File number: 8, Village: Edgemoor, Tenn.; Primary Registration District No.: 40109, Registered no.: 8.     R.F.D. #1
2. Full name -- Hulda Asberine Peters
3. Sex - female
4. Color or race - w
5. Singe, married, widowed, or divorced -- widowed
6. Date of birth -- Month Dec, Day 22, Year 1845
7. Age -- 70 yrs  3 mos.   17 ds.
8. Occupation -- housewife
9. Birthplace -- Tenn
10. Name of father -- Alfred Carter Cross
11. Birthplace of father -- Tenn
12. Maiden name of mother -- Zipporah Peters
13. Birthplace of mother -- Tenn
14. The above is true to the best of my knowledge (Informant) signed Hutsel Peters, Edgemoor  RFD#1
15. Filed 4/9, 1916  J.M. Cox
16. Date of death -- month Apr day 9, year 1916
17. I hereby certify that I attended from Sept 19, 1915 to Apr 9, 1916, and that I last saw her alive on month Feby 22, 1916 and that death occurred on the date stated above at 1:20 P.M.  The cause of death was as follows:  Chronic Valvular Heart Disease  Signed A.T. Stevens M.D., Apr 10, 1916 (Address) RFD#2
18. Length of residence
19. Place of burial or removal -- Scarbrough;  Date of burial -- Apr 10, 1916
20. Undertaker
 
The informant Hutsel Peters was Asberine's son Henry Hutsel (Hutsel) Peters.
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