Campbell County Death Certificates

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

 
Jake Leach
Reg. Number:  234; Reg. District: 1460
Certificate Number: 28508

IMAGE

Name: Jake Leach
Residence: Williamsburg, Whitley, KY
Sex: Male
Race: W
Date of Birth: 02 Nov 1900
Place of Birth: TN
Date of Death: 28 Nov 1982
Place of Death: Williamsburg, Whitley County, KY
Age: 82
Marital Status: Married
Spouse, if living: Viola Marlow
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: 400-03-9112
Occupation: Factory Worker
Industry or Business: (left blank)
Father's Full Name: Flim Leach
Father's Birthplace:
Mother's Full Maiden Name: Josephine Brown
Mother's Birthplace:
Cause of Death: Organic Brain Syncronie
  • Due to: Generalized Arteriosclenosis
  • 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: Viola Leach
Informant Address: Williamsburg, KY
Burial, Removal, or Cremation: Burial, Highland Cemetery, Williamsburg, KY
Date: 02 Dec 1982
Undertaker: Croley Funeral Home
Address: Williamsburg, KY
By:
Date Filed: 03 Dec 1982
Registrar: Nina W. Croley
Signature: unreadable, MD
Address: Williamsburg, KY

Submitter's Name: Bob Leach
Submitter's Email: bleach@rose.net
Relationship to the Deceased:

Comments: Jake's father's full name is James Fleming Leach.


 


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