The image below is a sample of the death certificate form used in Tennessee from 1908 through 1912. Each death certificate has thirteen fields of information; however, fields were sometimes left blank.
The fields are as follows:
- Name of deceased
- Date of death
- Sex
- Color or race
- Age
- Marital status
- Place of death
- Cause of death
- Place of birth
- Occupation
- Name of physician
- Name of coroner holding inquest
- Date recorded
Death certificates are stamped with an identification number near the upper right-hand corner.
