Campbell County Death Certificates

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

 
Mary Orick
Reg. Number:  143; Reg. District: 06
Certificate Number: 041650

Name: Mary Orick
Residence: Campbell County, Tennessee
Sex: Female
Race: White
Date of Birth: 02 Jan 1895
Place of Birth: Tennessee
Date of Death: 25 Jun 1967
Place of Death: St. Marys, Auglaize County, Ohio
Age: 72
Marital Status: Married
Spouse, if living:
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: unknown
Occupation: Homemaker
Industry or Business: (left blank)
Father's Full Name: Sherid Atkins
Father's Birthplace:
Mother's Full Maiden Name: Tramell
Mother's Birthplace:
Cause of Death: Pancytopenia
  • Due to: Squamous Cell Carcinoma Left Hard Palate
  • Other conditions: Diabetes Mellitus
  • Operation?: (left blank)
  • Autopsy?: No
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: Mr. Elvin Orick
Informant Address: Jellico, Tennessee
Burial, Removal, or Cremation: Burial
Date: 28 Jun 1967
Undertaker: Yoder & Long Funeral Home
Address: 314 West High Street, St. Marys, Ohio
By: C. Richard Long
Date Filed: 30 Jun 1967
Registrar: Hoy Cozad
Signature:
Address:

Submitter's Name: Leigh Ann (Partin) Boyd
Submitter's Email: LPartin@aol.com
Relationship to the Deceased: Great Grand Daughter

Comments: Buried in Jellico Cemetery. This is an Ohio Department of Health Certificate of Death.

 

 


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