Campbell County Death Certificates


Lewis M. Douglas
Reg. Number:  0103; Reg. District: 40103
Certificate Number: 50-12312


Name: Lewis M. Douglas
Residence: Route #2, Caryville, TN
Sex: Male
Race: W
Date of Birth: 22 Nov 1887
Place of Birth: Campbell County, TN
Date of Death: 05 Jun 1950
Place of Death: Scott Hospital, Lake City TN, Anderson County
Age: 62
Marital Status: Married
Spouse, if living: Myrtle (Arnett) Douglas
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: 413-09-8752
Occupation: Coal Miner
Industry or Business: Industry
Father's Full Name: Thomas Douglas
Father's Birthplace: Unknown
Mother's Full Maiden Name: Sallie (Douglas) Douglas
Mother's Birthplace: Unknown
Cause of Death: Pneumonia
  • Due to: Cerebral Hemmorage 10 days before
  • Other conditions: Cerebral Hemmorage 6 years before
  • Operation?: No
  • Autopsy?: No
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: Myrtle Douglas
Informant Address: Route #2, Caryville, TN
Burial, Removal, or Cremation: Burial in Douglas Cemetery near Jellico, TN
Date: 08 Jun 1950
Undertaker: Paul Martin
Address: Lake City, TN
By: Martin Funeral Home
Date Filed: 10 Jun 1950
Registrar: Rose M. Portwood, Dep.
Signature: R B Scott MD
Address: Lake City, TN

Submitter's Name: Anita Reish
Submitter's Email:
Relationship to the Deceased: Granddaughter




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