Campbell County Death

Lois Jean Massengill
Reg. Number:  23; Reg. District: 73
Certificate Number: 10313

Name: Lois Jean Massengill
Residence: District 3, Jacksboro, Campbell County, TN.
Sex: Female
Race: White
Date of Birth: 11 May 1941
Place of Birth: Tennessee
Date of Death: 11 May 1941
Place of Death: District 3, Jacksboro, Campbell County, TN.
Age: 3 hours and 30 minutes
Marital Status: Single
Spouse, if living: None
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: Left Blank
Occupation: None
Industry or Business: (left blank)
Father's Full Name: Claude Massengill
Father's Birthplace: Tennessee
Mother's Full Maiden Name: Dora Terry
Mother's Birthplace: Tennessee
Cause of Death: Prematurity
  • 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: Mr. Claude Massengill
Informant Address: Jacksboro, Campbell County, TN.
Burial, Removal, or Cremation: Raines Grove, Campbell County, TN.
Date: 12 May 1941
Undertaker: Martin Funeral Home
Address: Lake City, Tennessee
By: Paul Martin
Date Filed: 03 Jun 1941
Registrar: J.A. Nelson
Signature: A. A. Baird, M.D.
Address: Caryville, Tennessee

Submitter's Name: Melissa Barker
Submitter's Email:
Relationship to the Deceased: None

Comments: If anyone would like a copy of this original death certificate, please contact me.



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