CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS
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Ruby Harris
Reg. Number: (not on copy);
Reg. District: (not on copy)
Certificate Number: (not on copy)
Name: Ruby Harris
Residence: Barrett, Boone County, WV
Sex: Female
Race: White
Date of Birth: 17 Aug 1908
Place of Birth: Elk Valley, Campbell
Co, TN
Date of Death: 07 Jun 1999
Place of Death: Charleston Area Med
Ctr, Charleston, Kanawha Co WV
Age: 90
Marital Status: Widowed
Spouse, if living: (only listed if surviving
spouse, on this cert.)
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: (declined)
Occupation: Housewife
Industry or Business: (left blank)
Father's Full Name: Filetus Lewallen
Father's Birthplace: (no place on death
cert. for this)
Mother's Full Maiden Name: Jane Blankenship
Mother's Birthplace: (no place on death
cert. for this)
Cause of Death: Congestive heart failure
- Due to: Renal failure
- 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: (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: Credell Harris
Informant Address: Barrett, WV 25208
Burial, Removal, or Cremation: Hatfield
Cemetery, Barrett, Boone Co, WV
Date: 19
Undertaker: Ira C. Handley, Handley
Funeral Home, Inc
Address: P.O. Box 175, Danville, WV
25053
By: (no place on death cert. for this)
Date Filed: 19
Registrar: (not on copy)
Signature: (no place on death cert.
for this)
Address: (not on copy)
Submitter's Name: John C. Carter
Submitter's Email: spiff@atlantic.net
Relationship to the Deceased: Grandson
Comments: Date of burial is not given
on certificate, but was 09 Jun 1999. Her husband's full name
was Mont Washington Harris. Her mother's full name was Malinda
Jane Blankenship Lewallen.
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