CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS
Kelly Calony Sexton
Reg. Number: 17; Reg. District:
Certificate Number: 20019
Name: Kelly Calony Sexton
Residence: Turley,Campbell co. Tenn.
Date of Birth: 06 Nov 1905
Place of Birth: Campbell Tenn.
Date of Death: 02 Oct 1942
Place of Death: Turley, Campbell co.
Age: 36ys.10 months 26 days
Marital Status: Married
Spouse, if living: Mrs. Hazel Sexton
Age of Spouse, if living: 28
If Veteran, Name of War: left blank
Social Security Number: left blank
Industry or Business: (left blank)
Father's Full Name: Ewell Sexton
Father's Birthplace: Campbell Tenn.
Mother's Full Maiden Name: Mary Terry
Mother's Birthplace: Campbell Tenn.
Cause of Death: Motor drove over him
he was dead when I saw him
If death was due to external causes, fill
in the following:
- Due to: (left blank)
- Other conditions: No Inquest
- Operation?: (left blank)
- Autopsy?: (left blank)
Informant: Mrs. Ernie? Lay
- Accident, Suicide, or Homicide: Accident
- Date of Occurrence: 02 Oct 1942
- Where did the injury occur: Turley
Tenn. Coal mines
- Did injury occur in or about home,
on farm, in industrial place, in public place?: (left
- While at work: yes
- Means of Injury: Motor
Informant Address: Turley, Tenn.
Burial, Removal, or Cremation: Burial Turley cemetery
Date: 04 Oct 1942
Undertaker: Minton Sharp Funeral P
By: Nov. 10 1942
Date Filed: 02 Nov 1942
Registrar: J.H. Baird
Signature: Minton Sharp Coroner
Submitter's Name: Lorene McGhee
Submitter's Email: firstname.lastname@example.org
Relationship to the Deceased: Mothers
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