Personal Information Full Name Jackson, Carrie Notable Last Name Jackson First Name Carrie Middle Name Suffix Prefix Maiden Name Time lived in city Address 1403 Johnson Occupation Domestic Age at Death 45 Dates Date of Birth 11/ 1/ 1876 Date of Death 10/16/1921 Locations Hospital Birthplace Texas Father's Birthplace Mother's Birthplace Burial Death Certificate Y Cause of Death Malnutrition - Pellagra Undertaker E Jackson Plot# Inscription Family Spouse's Name Marital Status W Father's Name , Mother's Name ,