Date:   25 October 1944
Cert:   27656 
Place of Death: County: Knott     City or Town: Tina, Ky.  Rural
Name of Hospital or Institution: (blank)
Length of stay in hospital or community: (blank)
Usual Residence of Deceased: State: Kentucky    County: Knott
City or Town:  Tina     Rural
Full Name:  Mary TACKETT CAMPBELLE
If Veteran Name War: (blank)
Social Security No.: (blank)
Sex, Color or Race, Marital Status: Female, White, Married
Husband or Wife of:  Herman CAMPBELLE
Age of husband or wife if alive:  23 years
Birth date of deceased:  (blank)
Age: 17 years
Birthplace:  Breathitt Co., Ky.
Occupation:  Housewife
Industry or business: Housewife
Father Name:  Unknown
Father Birthplace:  (blank)
Mother Maiden Name:  Mrs. Fair ROBERTS, maiden name TACKETT first name not ascertained
Mother Birthplace:  Breathitt Co., Ky.
Informant:  Mrs. Fair ROBERTS, Tina, Ky.
Burial Place:  Roberts Cemetery
Date:  26 October 1944
Signature of funeral director: Friends of Family, Tina, Ky.
Date received by local registrar:  15 December 1944
Registrar's Signature:  Ida Livingston Rose B. Craft Acting Reg.
Date of Death:  25 October 1944
I hereby certify that I attended deceased from 25 October 1944 to 25 October 1944, that I last saw him alive on 25 October 1944, and that death occurred on the date stated above at 1:30 a.m.
Immediate cause of death: Uremic poisoning
Duration: (blank)
Due to: Kidney Disease
Other conditions:  25 October 1944 Gave birth to baby
Accident, suicide, or homicide: (blank)
Date of occurrence: (blank)
Where did injury occur: (blank)
While at work: (blank)
Means of injury: (blank)
Signature & Address: M. F. Kelley, M.D., Hindman, Ky.
Date signed:  16 December 1944
Transcribed by Debbie Tamborski, 07 November 2010