Dyer Co. TN Death Certificate for Samuel Wesley Reeves

CERTIFICATE OF DEATH
STATE OF TENNESSEE
Samuel Wesley Reeves

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CERTIFICATE OF DEATH
STATE OF TENNESSEE
Sam Wesley Reeves

Death No: 54-28752
Registration District Number: 791

1. Name: Sam Wesley Reeves
2. Date of Death: 12 31 1954
MONTH DAY YEAR

3. Color or Race: white
4. Sex: male
5. Single, married, widowed, divorced (specify): widowed
6. Date of Birth: 12 10 1876
MONTH DAY YEAR
7. Age (in years last birhtday): 78
8. Place of Death: 
A. County: Dyer
B. Civil District: 10
C. City or Town: Finley
D. Length of stay on this place: 10 years
E. Name of Hospital or Institution:
9. Usual Residence of Deceased: 
A. State: Tenn
B. County: Dyer
C. Civil District: 10
D. City or Town: Finley
E. Street Address:
10A. Usual Occupation: Retired
10B. Kind of Business or Industry: Tenant Farmer
11. Social security number:
12. Was Deceased Ever in U.S. Armed Forces? No
13. Birthplace: Henderson, Tenn.
14. Citizen of what country? U.S.A.
15. Father's Name: Jim Reeves
16. Mother's Maiden Name: Martha Pritchett
17. Informant: Mrs. Elbert Flatt; Finley, Tenn.
MEDICAL CERTIFICATION INTERVAL BETWEEN
ONSET AND DEATH
18. Cause of Death:
1. Disease or Condition directly leading to death: 
(A) Myocardial insufficiency 4 years
DUE TO (B) Arteriosclerosis, generalized years
DUE TO (C) Hypertension, arterial years
2. Other significant conditions
Internal hemorrhage 12 hours
19A. Date of Operation: 
19B. Major Findings of Operation:
20A. Autopsy: No
20B. Findings at Autopsy:
21A. Accident, Suicide, Homicide:
21B. Place of Injury (In or About Home, Farm, Factory, Street,
Office build'g, etc):
21C. Place of Injury:
21D. Time of Injury:
21E. Injury Occurred:
21F. How did injury occur:
22. I hereby certify that the deceased died on the date and from the cause
stated above:
SIGNATURE M.D. Other (Specify) Address Date
Orrin B. Landrum (signed) X Dyersburg, Tenn. 1-8-55
23A. Burial, cremation, removal (speficy): Burial
23B. Date of Burial, cremation, or removal: 1-2-55
23C. Name of Cemetery or Crematory: Fairview
23D. Location city, town or county state
Dyersburg, Dyer, Tennessee
24. Funeral Director Address
J. W. Curry & Son; Dyersburg, Tenn.
25. Registration Dist. No.: 42310
26. Date signed by local reg.: Jan 20, 1955
27. Registrar's signature: W. G. Shelton, MD (signed)

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