Marrell Jackson Dunn-- June 26, 1947
(Transcribed by David B Dunn)








B.V.S. FORM 11




                                                   NORTH CAROLINA STATE BOARD OF HEALTH                             227




BUREAU OF VITAL STATISTICS
CERTIFICATE OF DEATH                                                    Registration Dist. No. 3100 Certificate No. 43




1. PLACE OF DEATH:                                                      
    (a) County:  Duplin                                                          2. HOME (USUAL RESIDENCE) OF DECEASED:
    (b) Township: Warsaw                                                        (a) State: N. C.    (b) County: Duplin
    (c) City or Town: Rural                                                        (c) City or Town: Rural
    (d) Street, Hospital, institution: Blank                                   (d) Street or Rfd.: Blank
    (e) length of stay in hospital or institution: Blank                    (e) is place of residence in corporate limits: No
    in this community 6 years                                                   (f) if foreign born, how long in U.S.A.: Blank years
                                                                                                      MEDICAL CERTIFICATION
3. (a) Full Name: Marrell Jackson Dunn                                 20. Date of Death: 6-26-1947 at 6:15 pm                
    (b) if veteran, name war: blank                                          21. I certify that death occurred on the date above stated; that                             
    (c) Social Security No.: Blank                                              I attended deceased from Dec. 16, 1946 to June 26, 1947   
4. Sex: Male        5. Color or Race: White                                and that I last saw him alive on June 26, 1947.
6. (a) Marital status: Married                                                    immediate cause of death: 1. Congestive Heart Falure
    (b) Name of Wife: Winnie Dunn                                             2. Urema.  Duration 2 weeks.
7. Birth of Deceased: Oct. 18, 1881                                      22. If death was due to external causes, fill in the following:
8. Age: 66 Years                                                                         (a) Accident, suicide, or homicide: Blank
9. Birth Place: Duplin County                                                        (b) Date of occurrence: Blank
10. Usual Occupation: Farming                                                     (c) Where did injury occur: Blank 
11.Industry or Business: Blank                                                      (d) Did injury occur about home, on farm, in industry 
12. Fathers name: Henderson Dunn                                                  place, in a public place: blank
13. Birthplace of father: Duplin Co.                                                 (e)means of injury: blank
14. Mothers Maiden Name: Mattie Sullivan                          23. Signature: E. P.  Ewers
15. Birthplace of mother: Duplin                                                 Address: Warsaw, N.C. Date Signed 9-10-1947
16. (a) Informants Signature: W. J. Dunn
      (b) Informants address: #2 Warsaw, N.C.
17. (a) Burial Cremation or Removal: Burial
      (b) Date Thereof: 6-27-1947
      (c) Cemetery: Brock
      (d) Location: Serecta, Duplin co.
18. (a) Funeral Director: Quinn-McGowan Co.\
      (b) Address: Warsaw, N.C.
19  (a) Filed: 9-11-1947 (b) Registrar: illegible





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