Jewell London Death Certificate

STATE OF TENNESSEE

Dept. of Public Health    Div. of Vital Statistics

Cooperating with Dept. of Commerce   Bureau of the Census

CERTIFICATE OF DEATH # 25166

 

Full Name:                    Jewell London                    Date of death:  Nov. 25, 1941

Place of death:  Lewisburg, Civil Dist. 3, Marshall County

Name of Hospital:  Gordon's      Length of stay in hospital:  9 days   

                                                       Length of stay in community:  life

Legal Residence:  R. F. D. 5, Lewisburg, 2^nd Civil Dist., Marshall County

 

Color or Race:                          White

Sex:                                            Male

Marital Status:                          Married

Date of birth:                             July 3, 1909

Age at date of death:                 32 years, 4 months, 22 days

Social Security Number:          413-12-7006

Occupation:                               Running road grader for county

 

Husband of:                                Mary Lou London,  age 29

 

Father's full name:                    Enoch Cantrell London

Father's birthplace:                  Marshall County, Tenn.

Mother's maiden name:           Sarah Collins

Mother's birthplace:                Marshall County, Tenn.

Informant:                                Miss Zadie London (sister)  Lewisburg, Tenn. # 5

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MEDICAL CERTIFICATION

I HEREBY CERTIFY That I attended the deceased from Nov 7, 1941 to Nov 25, 1941 and that I last saw him alive on Nov 25, 1941, and that death occurred on the date stated at 1:15 a. m.

Immediate Cause of Death:  (1) Broncho peumonia

                                                 (2) Eniceration

                                                 (3) Peritonitis

                           Due to:               Acute appendicitis

Signed:  J. T. Gordon, M. D.          Lewisburg

________________________________________________________________________

Place of burial:  Round Hill near Belfast     date of burial:  Nov 25, 1941

Undertaker:      London Funeral Home      Lewisburg, Tenn.

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Submitted and Transcribed by Dick Woods, November 2004