Campbell County Death Certificates

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

 
Jasper Little
Reg. Number:  (Left Blank); Reg. District: 40705
Certificate Number: File No. 41

Name: Jasper Little
Residence: (Left Blank)
Sex: Male
Race: White
Date of Birth: 22 Nov 1850
Place of Birth: NC
Date of Death: 12 Oct 1926
Place of Death: Jellico, Tenn
Age: 75 yrs, 10 mos., 20 ds.
Marital Status: Widowed
Spouse, if living: Nettie Jane (Witt) Little
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number:
Occupation: Common Laborer
Industry or Business: (left blank)
Father's Full Name: "A" Little (First name is illegible)
Father's Birthplace: NC
Mother's Full Maiden Name: "Don't know"
Mother's Birthplace: NC
Cause of Death: Senility
  • Due to:
  • Other conditions: Paralysis
  • 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:
  • Did injury occur in or about home, on farm, in industrial place, in public place?: (left blank)
  • While at work:
  • Means of Injury:
Informant: G. W. Little
Informant Address: Jellico, Tenn
Burial, Removal, or Cremation: Cane Creek Kentucky
Date: 13 Oct 1926
Undertaker: Wm. Ray Ellison
Address: Jellico, Tenn.
By:
Date Filed: 03 Oct 1926
Registrar: L. L. Rienour
Signature: Wm. Gaylor, M.D.
Address: Jellico, Tenn.

Submitter's Name: Kristi Cox
Submitter's Email: ctrptrkdm@aol.com
Relationship to the Deceased: GG-Granddaughter

Comments: The filed date for this certificate says Oct. 03, 1926; however, he died on Oct. 12, 1926. The "03" should probably have been "13." The father's whole given name is written in, but is hard to decipher. Certificate also lists the Lenth of Residence at place of death: 6 yrs. In the State: 6 yrs. This death certificate is on a Commonwealth of Kentucky Certificate of Death. It lists the County as Whitley; however, that is crossed out and "Campbell" is written over it, and the Vot. Pct. is listed as Jellico, Tenn. and the City is listed as Jellico. It was actually filed with the State of TN, and not KY.


 


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