Cert: #49-21381
Name: Irland AMBURGEY
Date of Death: 05 October 1949
Color or Race, Sex, Marital Status: White, Male, Divorced
Date of Birth: 09 March 1895
Age: 54 years, 06 months, 26 days
Place of Death: County: Anderson Civil District: 1st.
City or Town: Clinton, Rural
Length of stay in this place: 13 month
Name of Hospital or Institution: R.F.D. #4
Usual Residence of Deceased: State: Tenn. County: Anderson
City or Town: Clinton, rural          Street Address: R.F.D. #4
Usual Occupation: Farmer
Kind of Industry or business: Farming & Laborer
Social Security No.: XXX-XX-XXXX
Was deceased ever in armed forces: No
Birthplace: Ky.
Father's Name: Robert AMBURGEY
Mother's Maiden Name: Julia FRANCIS
Informant: Mr. Rufe Yarber, Clinton, R.4.
Disease or condition directly leading to death: Cirrhosis of liver
Interval between onset and death: 2-3 years
Other significant conditions: Ascites
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Describe how injury occurred: (blank)
Time of injury: (blank)
Injury occurred at work: (blank)
Place of injury: (blank)
City, Town or Location, County, State: (blank)
I hereby certify that the deceased died on the date and from the cause stated above
Signature: Henry Hessen, Jr. M.D.
Address: Clinton, Tenn.
Date: 07 October 1949
Burial, Cremation or Removal: Burial
Date: 06 October 1949
Name of Cemetery or Crematory: Hilvale Cem.
Location: Clinton, Tenn. R.F.D. I.
Funeral director & address: Frank Martin, Clinton, Ten..
Registration Dist. No. 40101
Date Signed by Local Reg.: 21 October 1949
Registrar's Signature: Rose M. Portwood, Dep.
Transcribed by Debbie Tamborski, 06 August 2012