CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS
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Silas Stephens
Reg. Number: ; Reg. District:
Certificate Number: 70-010273
Name: Silas Stephens
Residence: North Tenn. Ave. LaFollette,
TN
Sex: Male
Race: WHITE
Date of Birth: 30 Jul 1891
Place of Birth: TENN.
Date of Death: 30 Apr 1970
Place of Death: LaFollette Hospital,
LaFollette, TENN.
Age: 78
Marital Status: Widowed
Spouse, if living:
Age of Spouse, if living:
If Veteran, Name of War: NO
Social Security Number: 408-05-4721
Occupation: Miner
Industry or Business: Industry
Father's Full Name: Josh Stephens
Father's Birthplace: No box for this
info
Mother's Full Maiden Name: Elizabeth
Trammell
Mother's Birthplace: No box for this
info
Cause of Death:
- 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:
- 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. Dimple Perkins
Informant Address: 59 Fountain Ave.
Burial, Removal, or Cremation: Burial:
Baird Cem. La Follette, TN R. #2
Date: 03 May 1970
Undertaker: Martin Funeral Home
Address: LaFollette, TENN.
By:
Date Filed: 06 May 1970
Registrar: Joyce Gail Boshears, Dep.
Reg.
Signature: Robert C. Boyer
Address:
Submitter's Name: Lisa Stephens
Submitter's Email: baronpool@earthlink.net
Relationship to the Deceased: great
niece in law
Comments: Silas was married to #1:
Melvina Bolinger, #2: Etta Martin, and #3: ______ Broyles. Silas
was born in Campbell Co. TN.
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