Death Certificate
of
Rebecca Mullins
Submitted by
STATE OF TENNESSEE
STATE BOARD OF HEALTH
CERTIFICATE OF DEATH
(File No. 2946, Reg. No. 12)
1. County: Gibson; Civil District: 13; City: Humboldt
2. Full Name: Ellen Rebecca Mullins
3. Sex: Female
4. Race: White
5. Marital Status: Widowed
6. Date of Birth: Jan. 7, 1847
7. Age: 80 years, 1 month, 3 days
8. Occupation: House Keeping
9. Birthplace: Madison County, TN
10.Name of Father: James H. Nelson
11.Birthplace of Father: Madison Co., Tenn
12.Name of Mother: Miss Sidies(?) Johnson
13.Birthplace of Mother: Madison Co., Tenn
14.Informant: B. L. Mullins, Humboldt, Tenn
15.Filed Mar. 11, 1930 by B.S. Penn, Registrar
16.Date of Death: Feb. 10, 1930
17.I HEREBY CERTIFY, That I attend deceased from Jan. 1929 to Feby. 10, 1930, that I last saw her alive on Feby. 10, 1930, and that the death occurred, on the date stated above, about 5:40 a.m.(?). The CAUSE OF DEATH was as follows: Nephritis. Duration: 2 years. Contributory causes: Not known. Signed, J. W. O__?__, Humboldt, Tenn. Filed 3-6-1930
18.(This section, Length of Residence, left blank.)
19.Place of burial: Antioch Cemetery on 2-11-1930
20.Undertaker: E. E. Bodkin & Son, Humboldt, Tenn.