CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS
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Wiley W Walden
Reg. Number: left blank;
Reg. District: 40705
Certificate Number: 5157
Name: Wiley W Walden
Residence: Jellico Route 1
Sex: Male
Race: Male
Date of Birth: 01 May 1871
Place of Birth: Clabourne Co Tennessee
Date of Death: 06 Mar 1937
Place of Death: Campbell Co Tennessee
Age: 69 yrs 10 months 5 days
Marital Status: Married
Spouse, if living: Elizabeth Walden
Age of Spouse, if living:
If Veteran, Name of War: left blank
Social Security Number: left blank
Occupation: farmer
Industry or Business: (left blank)
Father's Full Name: William Walden
Father's Birthplace: Tennessee
Mother's Full Maiden Name: Orlena Phillipps
Mother's Birthplace: Tennessee
Cause of Death:
- 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: Silas B Walden
Informant Address: Jacksboro Tenn
Burial, Removal, or Cremation: Walden
Date: 08 Mar 1937
Undertaker: Llewellen Fun Co
Address: Jellico Tenn
By: left bland
Date Filed: 20 Mar 1936
Registrar: L L Ridenour
Signature: Wm Gaylor
Address: Jellico Tenn
Submitter's Name: Joyce A Williams
Submitter's Email: wjwill3@bellsouth.net
Relationship to the Deceased: granddaughter
Comments: Filing date shows 1936,
should be 1937? Full name William Wiley Walden. Wiley Walden
was originally buried on Walden Farm on Hoot Owl Hollow Rd,
but later removed to Jellico City Cem, Jellico Tenn.
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