1. NAME: Ada Alsup Bush
2. DATE OF DEATH: 11-5-1949
3. COLOR OR RACE: W
4. SEX: F
5. MARRIED
6. DOB: 9-10-1883
7. AGE: 66
8. PLACE OF DEATH: DYERSBURG, DYER CO., CIVIL DISTRICT 4
9. USUAL PLACE OF RESIDENCE: CIVIL DISTRICT 4, DYER CO., TENN. 518 Bush St.
10. USUAL OCCUPATION: Housewife
11. SSN: --
12. ARMED FORCES: NO
13. PLACE OF BIRTH: Tennessee
14. CITIZENSHIP: U.S.
15. FATHER: Jessie Alsup
16. MOTHER'S MAIDEN NAME: Sally Lowens
17. INFORMANT: George D. Bush, Dyersburg, Tenn.
18. CAUSE OF DEATH: Coronary Occlusion – 6 hours
23A: BURIAL 23B: 11-7-1949 23C: Fairview, Dyersburg, Dyer County, Tenn.
24: J. W. Curry & Son Dyersburg, Tenn
25: REGISTRATION DIST NO: 22304
Nov 30, 1949 W. G. Shelton, M. D.