title

Campbell County TN Death Certificate

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

 

George Washington Williams
Reg. Number: Reg. District: 40705
Certificate Number: 59 21610


Name: George Washington Williams
Residence: Morley, TN
Sex: Male
Race: White
Date of Birth: 09 Sep 1887
Place of Birth: Tenn
Date of Death: 28 Sep 1959
Place of Death: Bethany Hosp Jellico
Age: 72
Marital Status: Married
Spouse, if living: Lulu Williams
Age of Spouse, if living: -
If Veteran, Name of War: no
Social Security Number: blank
Occupation: Miner
Industry or Business: (left blank)
Father's Full Name: Perry Williams
Father's Birthplace: -
Mother's Full Maiden Name: America Cornelius
Mother's Birthplace: -
Cause of Death: Cerebrovascular accident
  • Due to: (left blank)
  • Other conditions: pneumonia
  • 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: 22 Sep 19
  • Where did the injury occur: 1 week
  • 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: James Williams
Informant Address: Baltimore MD
Burial, Removal, or Cremation: burial
Date: 01 Oct 1959
Undertaker: Jellico funeral home
Address: Jellico TN
By: -
Date Filed: 07 Oct 1959
Registrar: Ayers
Signature: -
Address: -

Submitter's Name: Carl Davis
Submitter's Email: ciddddavis@citlink.net
Relationship to the Deceased: cousin

Comments: Joseph Fox MD Jellico Buried family Leach Cemetary



 


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