Death Certificate: State of Arkansas, State Board of Health

Certificate of Death 593, File No. 22, Registered No. 418

Registration District 418, Primary Registration District No. 6565

Full name on certificate: Mary Lunsford

Date of Death: June 4, 1922, 1:00 PM, at Blytheville, Arkansas

Female, white, child, age 7 months.

Occupation: Child

Birthplace: Arkansas

Name of Father: Versa [Verser] Lunsford

Birthplace: Tennessee

Maiden name of Mother: Glayds [Gladys] Ferguson

Birthplace: unknown

Informant: Versa [Verser] Lunsford, Blytheville, Arkansas

Cause of death, as stated on death certificate, Colitis.

Death certificate signed by C.C. Stevens, Undertaker

Attended from May 25, 1922 through June 4, 1922

by Dr. Ray, Blytheville, Arkansas

Death certificate signed June 11, 1922

Place of burial or removal: Clearlake, June 4, 1922