State of Tennessee Certificate of Death
Tennessee Death Certificate
File No: 459
Registered No: 450
County: Shelby City: Memphis
Place of Death: St. Joseph Hospital
Male, White, Single
Date of Birth: 12/13/1873
Occupation: Engine Foreman
Birthplace: Enid, Mississippi
Name of Father: Wilson Buckley
Birthplace of Father: Monticello, Mississippi
Mother Name: Frances Draper
Birthplace of Mother: KY
Informant: H.L. (Harry Livermore) Buckley (Emma's son) 336 Walker Avenue
Doctor Attended the deceased from 2/2/1918 to 2/13/1918
Death Occurred: 2-13-1918 at 10:30
Cause of Death: Lobar Pneumonia
Duration: 10 days
Contributory: Nephritis-Dysentery
Duration: 1 day
Length of Residence at Place of Death: 10 Days
Where was disease contracted: 336 Walker
Lived in TN: 25 Years
Former Residence: Enid, Mississippi
Burial: Elmwood Cem.
Date of Burial: 2-14-1918
Undertaker: J.J. Collins, Memphis, TN
Name of Informant: H.L. Buckley (Brother), 336 Walker
Filed: 2-18-1918
State of Tennessee Certificate of Death
Tennessee Death Certificate
File No: 459
Registered No: 450
County: Shelby City: Memphis
Place of Death: St. Joseph Hospital
Male, White, Single
Date of Birth: 12/13/1873
Occupation: Engine Foreman
Birthplace: Enid, Mississippi
Name of Father: Wilson Buckley
Birthplace of Father: Monticello, Mississippi
Mother Name: Frances Draper
Birthplace of Mother: KY
Informant: H.L. (Harry Livermore) Buckley (Emma's son) 336 Walker Avenue
Doctor Attended the deceased from 2/2/1918 to 2/13/1918
Death Occurred: 2-13-1918 at 10:30
Cause of Death: Lobar Pneumonia
Duration: 10 days
Contributory: Nephritis-Dysentery
Duration: 1 day
Length of Residence at Place of Death: 10 Days
Where was disease contracted: 336 Walker
Lived in TN: 25 Years
Former Residence: Enid, Mississippi
Burial: Elmwood Cem.
Date of Burial: 2-14-1918
Undertaker: J.J. Collins, Memphis, TN
Name of Informant: H.L. Buckley (Brother), 336 Walker
Filed: 2-18-1918
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