The Appalachia Fire Dept. responded with Rescue 3 and Heavy Rescue 3 to a MVC on Callahan Friday @ 1:36 p.m.  Upon arrival AFD personnel found a head on collision between a coal truck and a vehicle.   After initial size up was made a female patient was found pinned in the drivers seat.  AFD command ordered a MedaVac helicopter to meet at a staging location.  AFD personnel went to work on extrication duties while ARS conducted pt. assessment.   The patient was extricated and transferred to Wings Air Rescue.  The patient was taken to Holston Valley Medical Center Trauma Center where she later passed away.  The AFD members and family send our thoughts and prayers.