title

Campbell Death Certificate

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

 

J.T. Nelson
Reg. Number:  41; Reg. District: 71
Certificate Number: 28413

Name: J.T. Nelson
Residence: LaFollette RFD #2
Sex: Male
Race: White
Date of Birth: 20 Jul 1927
Place of Birth: LaFollette TN
Date of Death: 20 Dec 1945
Place of Death: LaFollette TN Civil District 3
Age: 18 years 4 months 20 days
Marital Status: Single
Spouse, if living: none
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number:
Occupation: Farmer
Industry or Business: (left blank)
Father's Full Name: Henry Nelson
Father's Birthplace: LaFollette TN
Mother's Full Maiden Name: Sarah Jane Goins
Mother's Birthplace: LaFollette TN
Cause of Death: Bullet wound in head
  • Due to: 22 bullet through head
  • 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: Accident
  • Date of Occurrence: 20 Dec 1945
  • Where did the injury occur: LaFollette, Campbell, TN
  • Did injury occur in or about home, on farm, in industrial place, in public place?: Farm
  • While at work: hunting
  • Means of Injury: Rifle
Informant: Henry Nelson
Informant Address: LaFollette TN RFD #2
Burial, Removal, or Cremation: Burial at Goins Cemetery
Date: 22 Dec 1945
Undertaker: Cross Funeral Home
Address: Caryville TN
By: BS Cross
Date Filed: 01 Mar 1946
Registrar: Alice C Murray
Signature: J.V. Presle
Address: LaFollette TN

Submitter's Name: Suzanne Pratt
Submitter's Email: swmpratt@swmpratt.com
Relationship to the Deceased: cousin

Comments: Source: Campbell County Death Certificate

 


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