Calvin Leeper Coffey Death Certificate
STATE OF TENNESSEE
CERTIFICATE OF DEATH
1914 Bedford County # 86
FULL NAME: Calvin Leeper Coffey
PLACE OF DEATH: Civil Dist. 19, Bedford County, Tenn.
Male
White
Single
Occupation: Farmer 000
Birth place: South Carolina
Date of death: 18 Apr 1914
Date of birth: 29 Jan 1830
Age at date of death: 84 years, 2 months, 20 days
Cause of death: Heart failure 205a
No attending physician
Father's name: Thomas Coffee born South Carolina
Mother's maiden name: Polly Miller born South Carolina
Informant: Mrs. Tom Woodard Shelbyville, Tenn.
Undertaker: L. Fowler, Lewisburg, Tenn.
Burial date: 19 Apr 1914
Burial place: Round Hill Cemetery
STATE OF TENNESSEE
CERTIFICATE OF DEATH
1914 Bedford County # 86
FULL NAME: Calvin Leeper Coffey
PLACE OF DEATH: Civil Dist. 19, Bedford County, Tenn.
Male
White
Single
Occupation: Farmer 000
Birth place: South Carolina
Date of death: 18 Apr 1914
Date of birth: 29 Jan 1830
Age at date of death: 84 years, 2 months, 20 days
Cause of death: Heart failure 205a
No attending physician
Father's name: Thomas Coffee born South Carolina
Mother's maiden name: Polly Miller born South Carolina
Informant: Mrs. Tom Woodard Shelbyville, Tenn.
Undertaker: L. Fowler, Lewisburg, Tenn.
Burial date: 19 Apr 1914
Burial place: Round Hill Cemetery
Calvin Leeper Coffey Death Certificate
STATE OF TENNESSEE
CERTIFICATE OF DEATH
1914 Bedford County # 86
FULL NAME: Calvin Leeper Coffey
PLACE OF DEATH: Civil Dist. 19, Bedford County, Tenn.
Male
White
Single
Occupation: Farmer 000
Birth place: South Carolina
Date of death: 18 Apr 1914
Date of birth: 29 Jan 1830
Age at date of death: 84 years, 2 months, 20 days
Cause of death: Heart failure 205a
No attending physician
Father's name: Thomas Coffee born South Carolina
Mother's maiden name: Polly Miller born South Carolina
Informant: Mrs. Tom Woodard Shelbyville, Tenn.
Undertaker: L. Fowler, Lewisburg, Tenn.
Burial date: 19 Apr 1914
Burial place: Round Hill Cemetery
STATE OF TENNESSEE
CERTIFICATE OF DEATH
1914 Bedford County # 86
FULL NAME: Calvin Leeper Coffey
PLACE OF DEATH: Civil Dist. 19, Bedford County, Tenn.
Male
White
Single
Occupation: Farmer 000
Birth place: South Carolina
Date of death: 18 Apr 1914
Date of birth: 29 Jan 1830
Age at date of death: 84 years, 2 months, 20 days
Cause of death: Heart failure 205a
No attending physician
Father's name: Thomas Coffee born South Carolina
Mother's maiden name: Polly Miller born South Carolina
Informant: Mrs. Tom Woodard Shelbyville, Tenn.
Undertaker: L. Fowler, Lewisburg, Tenn.
Burial date: 19 Apr 1914
Burial place: Round Hill Cemetery
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