CERTIFICATE OF DEATH
STATE OF TENNESSEE

Registrtation District Number: 231
Primary Registration District No: 4
File Number: 74
Registered: 161

1. Place of Death:
   County : Dyer
   Civil Dist: 4
   City: Dyersburg
2. Full name: Mrs. Allice Baine
3. Sex: Female
4. Color or Race: White
5. Single, Married, Widowed, or Divorced: Married
6. Date of Birth:
7. Age: 54 yrs. 2 mos. 8 da.
8. Occupation
  a) Trade, profession, or particular kind of work: House Wife
9. Birthplace: Do
10. Name of Father: Thos Presley
11. Birthplace of Father: Do
12. Maiden Name of Mother: Miss Elizabeth Carpenter
13. Birthplace of Mother: Do
14. The above is true to the best of my knowledge
    (informant): Abe Bane
    (address): Dyersburg Tenn
15. Filed: 6-14, 122    Madie Anderson
                          Registrar

16. Date of Death: June 9, 1922
17. I hereby certify, that I attended deceased from Mch 1922, to
    June, 1922, that I last saw her alive on ? June, 1922, and that
    death occurred, on the date stated above, at _?_m.

    The cause of death was as follows: cancer of uterus

    Duration: 2 yrs.

    (signed) A. H. Moody, M.D.
    June 9, 1922 (address) Dyersburg, Tenn

18. Length of Residence (for hospitals, institutions, transients,
                         or recent residents):
19. Place of Burial or Removal: Pleasant Hill   Date of Burial: June 10, 1922
20. Undertaker: JW Curry & Son  Address: Dyersburg