Date: 12 July 1951
Cert: 14596
Place of Death: County: Knott
City or Town: Rural
Length of stay (in this place): All of life
Street address or location: Mousie, Ky.
Usual Residence of Deceased: State: Ky.
County: Knott
City or Town: Rural If rural give
precinct: Mousie, Ky.
Full Name: Eliza CAMPBELL
Date of Death: 12 July 1951
Sex, Color or Race, Marital Status: Female, White, Widowed
Date of Birth: 06 March 1871
Age: 80 years
Usual Occupation: Housewife
Kind of Industry or business: Keeping House
Birthplace: Knott Co., Ky.
Father's Name: John WICKER
Mother's Maiden Name: Rebecca WALLEN
Was deceased ever in armed forces: (blank)
Social Security No.: (blank)
Informant: T. C. CAMPBELL
Disease or condition directly leading to death: (blank)
Interval between onset and death: (blank)
Due to: Coronary Thrombosis
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy: No
Accident, suicide, or homicide: (blank)
Place of injury: (blank)
City or Town, County, State: (blank)
Time of Injury: (blank)
Injury occurred at work: (blank)
How did injury occur: (blank)
I hereby certify that I attended deceased from 08 July 1951 to
12 July 1951, that I last saw the deceased alive on 12 July
1951, and
that death occurred at 3:00 p.m., from the causes and on the
date stated above.
Date signed: 17 July 1951
Address: Garrett, Ky.
Signature: C. B. Ison, M.D.
Burial, Cremation or Removal: Burial
Date: 15 July 1951
Name of Cemetery or Crematory: Campbell Cemetery
Location: Mousie, Ky.
Date received by local registrar: 17 July 1951
Registrar's Signature: Rose B. Craft
Funeral director & address: John N. Taul, Hindman,
Ky.
Transcribed by Debbie Tamborski, 18 January 2011 |