title

Campbell Death Certificate

CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS

 

Isaac George Orick
Reg. Number:  0748240700; Reg. District: 20701
Certificate Number: 58-22228


Name: Isaac George Orick
Residence: Civil dist. 5 Campbell Co. ,TN
Sex: Male
Race: white
Date of Birth: 03 Mar 1879
Place of Birth: Kentucky
Date of Death: 31 Aug 1958
Place of Death: Lafollette
Age: 79
Marital Status: Married
Spouse, if living: Laura
Age of Spouse, if living: n/a
If Veteran, Name of War:
Social Security Number: 411-14-6548
Occupation: Post Master
Industry or Business: Business
Father's Full Name: Russell Orick
Father's Birthplace: n/a
Mother's Full Maiden Name: Eliza Bailey
Mother's Birthplace: n/a
Cause of Death: Heptic coma
  • Due to: Ca. of stomach
  • Other conditions: (left blank)
  • Operation?: (left blank)
  • Autopsy?: No
If death was due to external causes, fill in the following:
  • Accident, Suicide, or Homicide: (left blank)
  • Date of Occurrence: 19
  • Where did the injury occur: (left blank)
  • Did injury occur in or about home, on farm, in industrial place, in public place?: (left blank)
  • While at work: (left blank)
  • Means of Injury: (left blank)
Informant: Laura Orick
Informant Address: Duff, TN
Burial, Removal, or Cremation: burial
Date: 03 Sep 1958
Undertaker: n/a
Address: LaFollette,TN
By: Cross & Berry
Date Filed: 15 Sep 1958
Registrar: Margaret H. Ayers
Signature: John C. Pryse M.D.
Address: LaFollette

Submitter's Name: Sherman F. Orick
Submitter's Email: knxorick@aol.com
Relationship to the Deceased: grandson

Comments: Buried at Peabody Cemetary


 


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