Texas Department of Health
Bureau of Vital Statistics
Standard Certificate of Death
Place of Death: Grand Saline, Van Zandt County, TX
Full Name of Deceased: JOSIE JACKSON
Length of Residence Where Death Occurred: 40 years
Residence: Grand Saline, Van Zandt County, TX
Sex: Female
Color or Race: White
Marital Status: Married
Date of Birth: Dec. 7, 1866
Age: 81y 4m 11d
Occupation: Housewife
Birthplace: Texas
Father's Name: Samuel T. Kelly
Father's Birthplace: Georgia
Mother's Maiden Name: Harriett N. Mingo
Mother's Birthplace: Georgia
Signature: T.L. Courtney, Grand Saline, Texas
Burial: Woodside, Van Zandt, TX
Date of Burial: April 20, 1948
Undertaker: Bailley, Grand Saline
Date of Death: April 18, 1948, 11:30 p.m.
Primary Cause of Death: Accidental Fracture of [***]
Signature: Garland, M.D., Grand Saline, Texas
____________________________________
Bureau of Vital Statistics
Standard Certificate of Death
Place of Death: Grand Saline, Van Zandt County, TX
Full Name of Deceased: JOSIE JACKSON
Length of Residence Where Death Occurred: 40 years
Residence: Grand Saline, Van Zandt County, TX
Sex: Female
Color or Race: White
Marital Status: Married
Date of Birth: Dec. 7, 1866
Age: 81y 4m 11d
Occupation: Housewife
Birthplace: Texas
Father's Name: Samuel T. Kelly
Father's Birthplace: Georgia
Mother's Maiden Name: Harriett N. Mingo
Mother's Birthplace: Georgia
Signature: T.L. Courtney, Grand Saline, Texas
Burial: Woodside, Van Zandt, TX
Date of Burial: April 20, 1948
Undertaker: Bailley, Grand Saline
Date of Death: April 18, 1948, 11:30 p.m.
Primary Cause of Death: Accidental Fracture of [***]
Signature: Garland, M.D., Grand Saline, Texas
____________________________________
Texas Department of Health
Bureau of Vital Statistics
Standard Certificate of Death
Place of Death: Grand Saline, Van Zandt County, TX
Full Name of Deceased: JOSIE JACKSON
Length of Residence Where Death Occurred: 40 years
Residence: Grand Saline, Van Zandt County, TX
Sex: Female
Color or Race: White
Marital Status: Married
Date of Birth: Dec. 7, 1866
Age: 81y 4m 11d
Occupation: Housewife
Birthplace: Texas
Father's Name: Samuel T. Kelly
Father's Birthplace: Georgia
Mother's Maiden Name: Harriett N. Mingo
Mother's Birthplace: Georgia
Signature: T.L. Courtney, Grand Saline, Texas
Burial: Woodside, Van Zandt, TX
Date of Burial: April 20, 1948
Undertaker: Bailley, Grand Saline
Date of Death: April 18, 1948, 11:30 p.m.
Primary Cause of Death: Accidental Fracture of [***]
Signature: Garland, M.D., Grand Saline, Texas
____________________________________
Bureau of Vital Statistics
Standard Certificate of Death
Place of Death: Grand Saline, Van Zandt County, TX
Full Name of Deceased: JOSIE JACKSON
Length of Residence Where Death Occurred: 40 years
Residence: Grand Saline, Van Zandt County, TX
Sex: Female
Color or Race: White
Marital Status: Married
Date of Birth: Dec. 7, 1866
Age: 81y 4m 11d
Occupation: Housewife
Birthplace: Texas
Father's Name: Samuel T. Kelly
Father's Birthplace: Georgia
Mother's Maiden Name: Harriett N. Mingo
Mother's Birthplace: Georgia
Signature: T.L. Courtney, Grand Saline, Texas
Burial: Woodside, Van Zandt, TX
Date of Burial: April 20, 1948
Undertaker: Bailley, Grand Saline
Date of Death: April 18, 1948, 11:30 p.m.
Primary Cause of Death: Accidental Fracture of [***]
Signature: Garland, M.D., Grand Saline, Texas
____________________________________
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