Certificate of Death

John D. Yates
submitted by

STATE OF TENNESSEE
STATE DEPARTMENT OF HEALTH
Division of Vital Statistics
Certificate of Death

1. Place of Death - County: Gibson; Civil District: 15
2. Full Name: John D. Yates
3. Sex: M
4. Color or Race: White
5. Single, Married, Widowed or Divorced: Married
6. Date of Birth: Jan. 14, 1862
7. Age: 70 years, 2 months, 7 days
(8, 9, 10, 11 all left blank, occupation section)
12. Birthplace: Tenn.
13. Father Name: Math Yates
14. Father Birthplace: Tenn.
15. Mother Name: Marry Lock* (or Lack?? Almost illegible)
16. Mother Birthplace: Tenn.
17. Informant: John McCartney, Bradford, Tenn.
18. Burial, Cremation, or Removal: Idlewild, Tenn.; Date: 3/22, 1932
19. Undertaker: Hunt Bros., Bradford, Tenn.
20. Filed: 4/10, 1932; Essie Rhodes, Registrar
MEDICAL CERTIFICATE OF DEATH
21. Date of Death: Mar. 21, 1932
22. I HEREBY CERTIFY, That I attended deceased from March 1931 to March 1932.
I last saw him alive on March 18, 1932; death is said to have occurred on the date
stated above at __________.
The principal cause of death and related causes of importance in order of onset were
as follows: Myocorditis; Influenza - date of onset October 1918.
(23 and most of 24 left blank)
24. Signed C E S_(?) (nearly illegible), Trenton, Tenn.

Marry Lack (or Lock) is listed as the mother of John Yates.  However, research shows that his mother is listed in census records as “Barbara Ann.”  There is not enough evidence at this time to rightfully state the true name of his mother.