| 1. Place of Death | 1224 3rd Ave North, Nashville, Davidson County, Tennessee |
| 2. Full Name | Mrs. Barbara Diatikar |
| 3. Sex | Female |
| 4. Race | White |
| 5. Marital Status | Married |
| 6. Date of Birth | [17 Feb 1859] |
| 7. Age | 58 |
| 8. Occupation | Housekeeper |
| 9. Birthplace | Tenn [Tennessee] |
| 10. Name of Father | Peter Brunold |
| 11. Birthplace of Father | Switzerland |
| 12. Maiden Name of Mother | Anna Staub |
| 13. Birthplace of Mother | Switzerland |
| 14. Informant | Mrs Mary Potter, Nashville, Tenn. |
| 15. Filed | [26 Dec 1917] |
| 16. Date of Death | [21 Dec 1917] |
| 17. Certification & Cause | Pellagra [Vitamin Deficiency] |
| 18. Length of Residence | [blank] |
| 19. Place of Burial | Mt Olivet Cemetery [Nashville, TN] |
| 19. Date of Burial | [23 Dec 1917] |
| 20. Undertaker | Dorris, Karsch, & Co |
| 20. Address | City [Nashville] |
Author’s notes in ‘[ ]‘
