Name: Dock John Monday
Residence: Campbell Co. Tenn
Sex: Male
Race: white
Date of Birth: 23 Jan 1872
Place of Birth: Claiborne Co. Tenn
Date of Death: 31 Mar 1965
Place of Death: LaFollette, Campbell Co. Tenn
Age: 93
Marital Status: Widowed
Spouse, if living: Frances Monday
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number:
Occupation: farmer
Industry or Business: (left blank)
Father's Full Name: John Monday
Father's Birthplace:
Mother's Full Maiden Name: Mary Turner
Mother's Birthplace:
Cause of Death: not listed

• Due to: (left blank)
• 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: Mrs. Luther Carroll
Informant Address: Speedwell Tenn
Burial, Removal, or Cremation: Burial
Date: 02 Apr 1965
Undertaker: Cross Funeral Home
Address: LaFollette Tenn
By:
Date Filed: 09 Apr 1965
Registrar: Nancy Beever?
Signature:
Address:

Submitter's Name: Carol Woodward
Submitter's Email: carol@tc3net.com
Relationship to the Deceased: cousin

Comments: Died in LaFollette Hospital