Mary Jane Dunn Death Certificate-- March 7, 1922
(Transcribed by David B Dunn)
B.V.S. FORM 11
NORTH CAROLINA STATE BOAD OF HEALTH 214
BUREAU OF VITAL STATISTICS
CERTIFICATE OF DEATH
Registration No. 10
1. Place of Death :
County: Kenansville N.C.
2. Full Name: Mary Jane Dunn (c) City or Town: Blank
3. Sex: Female 4. Color: White 5. Marital Status: Widowed
5a. Husband: Ben Dunn 6. Date of Birth: Blank 7. Age: 71 Years
8. Trade: Blank 9. Industry: Blank 10. Last day worked: Blank
11. Total Time spent in this occupation: Blank 12. Birthplace: Blank
13. Name of Father: Elisha Sullivan 14. Birthplace: Duplin Co.
15. Name of Mother: Nancy Jane Blalock 16. Birthplace: Duplin Co.
17. Informant: Ransom Brock 18. Burial: Sarecta March 7, 1932
19 Undertaker Quinn McGowan 20. Filed 7-27-1932 D. N. Brock Registrar
MEDICAL CERTIFICATE OF DEATH
21. Date of Death: March 6, 1932
22. I hereby CCertify that I attended deceased from March 1, 1932 to March 6, 1932. I last
saw her alive March 6, 1932 deate is said to have occurred on the date stated above, at 5:00
pm. The principal cause of death and related causes of importance in order of onset were as
follows:
Chronical Myorloctis(?)
23: Blank
24. Signed: G.V. Gooding Kennansville N.C.
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