Death Certificates

D - F

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E

F

Floyd, John C.

Mississippi State Board of Health    #1904

Place of Death - Shubuta, Clarke County, Miss.            Registration District No. - 1120           Record No. 5

Primary Registration District No. - 4095

Full Name - John C. Floyd

Residence - (not given)

Sex - Male        Color or Race - White        Marital Status - Married

Spouse's Name - Octavia Bethea Floyd

Date of Birth - Feby. 26, 1864

Age - 60

Occupation of Deceased - Farmer

Birthplace - Miss.

Name of Father - Jim Floyd                     Birthplace of Father - S. C.

Maiden Name of Mother - Anna Jane Smith            Birthplace of Mother - N. C.

Informant - Mrs. Buffington                                     Address - Shubuta, Miss.

Filed - 2/20/1924                                           Registrar - Albert Hand

Date of Death - Feby. 18, 1924

I hereby certify, that I attended the deceased from __________. 1920 to 2/18, 1924, that I last her alive on 2/18, 1926, and that death occurred on the date stated above at 8 a.  m. The cause of death was as follows:    Pulmonary Tuberculosis

Signed: Albert Hand, M. D.                                      2/20//1924                                        Address - Shubuta, Miss.

Place of Burial, Cremation, or Removal - Shubuta            Date of Burial - 2/20/1924

Undertaker - W. H. Patton & Son            Address - Shubuta, Miss.            Date of Burial - 2/20/1924

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