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
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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