Questions: (Transcription Notes)
1. Number of the family as given in column Number 2. Schedule 1.
2. Name of the person deceased.
Personal Description.
3. Age at last birthday, If under 1 year give months in fractions, if under 1 month give days in fractions
4. Male (M) or Female (F)
5. Color - White (W) Black (B) Mulatto (M) Chicano (C) Indian (I)
What was the civil condition of the person who died? (use 1)
6. Single (S)
7. Married (M)
8. Widowed (W) Divorced (D)
NATIVITY
9. Place of birth of this person, including the state or Territory of the U.S., or the country, if of foreign birth.
10.Where was the Father of this person born? (with persons name, if not in Georgia)
11. Where was the Mother of this person born (with persons name, if not in Georgia)
12. Profession, Occupation or Trade. (Not to be asked in respect to persons under 10 years of age.)
13. The month in which the person died.
14. Disease or cause of death.
15. How long is resident of the county. If less than 1 year state months in fractions.
16. If the disease was not contracted at place of death, state the place. (if any will be in remarks at bottom of page)
17. Name of attending Physician