Campbell Death Certificate CERTIFICATE OF DEATH STATE OF TENNESSEE DEPARTMENT OF PUBLIC HEALTH DIVISION OF VITAL STATISTICS   Nick Nelson Reg. Number:  194; Reg. District: 40705 Certificate Number: 12057 Name: Nick Nelson Residence: Jellico Campbell TN Sex: Male Race: White Date of Birth: 01 Aug 1884 Place of Birth: Union TN Date of Death: 05 Apr 1948 Place of Death: Jellico Campbell TN Age: 73 years 8 months 4 days Marital Status: Married Spouse, if living: Linda Ford Nelson Age of Spouse, if living: 78 If Veteran, Name of War: Social Security Number: Occupation: odd jobs Industry or Business: (left blank) Father's Full Name: William Nelson Father's Birthplace: Tennessee Mother's Full Maiden Name: Jane Anderson Mother's Birthplace: Tennessee Cause of Death: Carcinoma of prostrate 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: 19 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. Nick Nelson Informant Address: Elk Valley, Tenn. Burial, Removal, or Cremation: Burial at Ford Cemetery Date: 08 Apr 1948 Undertaker: Llewellyn's Funeral Address: Jellico Tenn By: L.F. Mann Date Filed: 05 Jul 1948 Registrar: Eloise P. Jones Signature: Charles A. Prater Address: Jellico, TN Submitter's Name: Suzanne Pratt Submitter's Email: swmpratt@swmpratt.com Relationship to the Deceased: none Comments: Source: Campbell County Death Certificate

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