Campbell County Death Certificates

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

 
Roy Adkins
Reg. Number:  293; Reg. District: 4070
Certificate Number: 21159

IMAGE

Name: Roy Adkins
Residence: Caryville, Tennessee R. # 2
Sex: Male
Race: white
Date of Birth: 17 Jul 1909
Place of Birth: Tenn.
Date of Death: 21 Oct 1948
Place of Death: Royal Blue, Tennessee
Age: 39 years, 3 months, 4 days
Marital Status: Married
Spouse, if living: Trula Douglas
Age of Spouse, if living: 89
If Veteran, Name of War:
Social Security Number:
Occupation: Coal Miner
Industry or Business: Industry
Father's Full Name: J. M. Adkins
Father's Birthplace:
Mother's Full Maiden Name: Margaret Lloyd
Mother's Birthplace:
Cause of Death: Accident
  • Due to: Mine Accident
  • Other conditions: (left blank)
  • Operation?: No
  • Autopsy?: No
If death was due to external causes, fill in the following:
  • Accident, Suicide, or Homicide: Accident
  • Date of Occurrence: 21 Oct 1948
  • Where did the injury occur: Royal Blue, Campbell, Tenn.
  • Did injury occur in or about home, on farm, in industrial place, in public place?: Industrial Place
  • While at work: Yes
  • Means of Injury: Mine Motor
Informant: Anita Reish
Informant Address: Ohio
Burial, Removal, or Cremation: Burial
Date: 24 Oct 1948
Undertaker: Paul Martin
Address: Lake City, Tenn.
By: Martin Funeral Home
Date Filed: 26 Oct 1948
Registrar: Elsie P. Jones
Signature: Oliver De Losier MD
Address: Royal Blue TN

Submitter's Name: Anita Reish
Submitter's Email: areish@bright.net
Relationship to the Deceased: Daughter

Comments:


 


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