PERSONAL AND STATISTICAL PARTICULARS
1. Place of death: County: Calloway, Voting precinct: S. Concord
2. Full name: W.W. Baucum
3. Sex: Male
4. Color or race: White
5. Single, married, widowed, or divorced: Married
6. Date of birth: Jan. 31, 1842
7. Age: 80 yrs., 9 months, 17 days
8. Occupation: Farmer
9. Birthplace: Tenn.
12. Name of father: Wyatt Baucum
13. Birthplace: N.C.
14. Maiden name of mother: Elizabeth Swan
15. Birthplace of mother: N.C.
16. The above is true to the best of my knowledge: [Informant] W.A. Baucum

MEDICAL CERTIFICATE OF DEATH
20. Date of death: Nov. 18, 1922
21. I HEREBY CERTIFY That I attended deceased from Nov. 12, 1922, to Nov. 18, 1922, that I last saw him alive on Nov. 17, 1922, and that death occurred, on the date stated above, at 3 am.
The cause of death was as follows: Infirmities of age