Deceased: Manervie Clardy

Registration Number: 123
Registration District: 643
Certificate Number: 271
Sex: Female
Race: Black
Date of Birth: 30 Dec 1903
Place of Birth: Clarksville, Montgomery County, TN.
Date of Death: 04 Jul 1918
Place of Death: Clarksville, TN.
County of Death: Montgomery County, TN.
Age: 14
Marital Status: Single
Age of Spouse, if living:
If veteran, name of war:
Social Security Number:
Occupation: School Girl
Industry or business: (left blank)
Father's Full Name: Sam Clardy
Father's Birth Place: Tennessee
Mother's Full Maiden Name: Minnie Beaumont
Mother's Birth Place: Tennessee
Cause of death: Pulmonary Tuberculosis
Due to: (left blank)
Other Conditions: (left blank)
Operation?: (left blank)
Autopsy?: (left blank)
Accident, Suicide,or Homicide: (left blank)
Date of Occurrence:   19
Where did the injury occur: (left blank)
Did the injury occur in or about home, or farm, in industrial place, in
public place?: (left blank)
While at work?: (left blank)
Means of injury: (left blank)
Informant: Sam Clardy
Informant Address: Clarksville, TN.
Burial, Removal, or Cremation: Burial-Mt. Olive Cemetery
Date of Burial: 05 Jul 1918
Undertaker: Not Legiable
Address: 101 Commerce
Date Filed: 09 Aug 1918
Registrar: R. B. Macon
Signature: Bryce Runyon M.D.
Address: Clarksville, TN.

Submitted by Suzanne Pratt at swmpratt@goodscentscandles.us <swmpratt@goodscentscandles.us>