Campbell Death Certificate



Daisy Mae Walden
Reg. Number:  0700; Reg. District: 20701
Certificate Number: 65-033010

Name: Daisy Mae Walden
Residence: 1st dist. Campbell Co.
Sex: Female
Race: white
Date of Birth: 01 Aug 1899
Place of Birth: Williamsburg,KY
Date of Death: 01 Dec 1965
Place of Death: Lafollette,TN
Age: 67
Marital Status: Married
Spouse, if living: George W. Walden
Age of Spouse, if living: 67
If Veteran, Name of War:
Social Security Number: 415-50-5601
Occupation: Housewife
Industry or Business: (left blank)
Father's Full Name: Robert Walls
Father's Birthplace: n/a
Mother's Full Maiden Name: Venia Johnson
Mother's Birthplace: n/a
Cause of Death: subarcachnoid hemorrage
  • 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: George Walden
Informant Address: Lafolllette
Burial, Removal, or Cremation: burial
Date: 04 Dec 1965
Undertaker: Walters
Address: Lafollette
By: Walters
Date Filed: 21 Dec 1965
Registrar: Nancy Beenen, Dep. Reg.
Signature: John C. Pryre M.D.
Address: Lafollette,TN

Submitter's Name: Sherman Orick
Submitter's Email: knxorick
Relationship to the Deceased: grandson

Comments: buried at Peabody Cemetary.Have census information



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