Campbell County Death Certificates

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

 
Isaac Green
Reg. Number:  10; Reg. District: 73
Certificate Number: 0703

Name: Isaac Green
Residence: Jacksboro, Campbell County,Tn.
Sex: Male
Race: White
Date of Birth: 06 Mar 1861
Place of Birth: Jacksboro,Rural, Campbell Co.Tn.
Date of Death: 11 Jan 1941
Place of Death: Jacksboro, Campbell County,Tn.
Age: 79 years 10 months 5days
Marital Status: Married
Spouse, if living: Maude (Graves) Green
Age of Spouse, if living: 30
If Veteran, Name of War:
Social Security Number: none
Occupation: Farmer
Industry or Business: (left blank)
Father's Full Name: Richard Green
Father's Birthplace: Cullpepper,Va.
Mother's Full Maiden Name: Mary Jane Hutson
Mother's Birthplace: Sullivan,Va.
Cause of Death: Labored Pneumonia
  • Due to: (left blank)
  • Other conditions: (left blank)
  • Operation?: (left blank)
  • Autopsy?: (left blank)
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: Mrs. John Reynolds
Informant Address: 116 E.43 ST. Covington, Ky.
Burial, Removal, or Cremation: Burial
Date: 13 Jan 1941
Undertaker: Agee & Walters
Address: LaFollotte
By: Walters
Date Filed: 02 Apr 1941
Registrar: G.A. Nelson
Signature: S.D. Queener
Address: Jacksboro

Submitter's Name: Billie Sue Stinnett
Submitter's Email: rbsjan7@aol.com
Relationship to the Deceased: Grandaughter

Comments: Grandpa Isaac's date of birth is wrong. It should be March 6,1859. His age at death should be 82 years 9 months 11 days. Also wrong is my grandmothers age. She was born 1902. Her age should be 39 years instead of 30 years.

 



 


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