Death Certificate of Alma Ezzell Blythe

Alma Ezzell Blythe, 55, died on 17 Apr 1990 in Norfolk from respiratory
failure due to pulmonary hemorrhage. A resident of Sedley, she was
married to Sherman L. Blythe and was buried at Southampton Memorial Park.

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Mrs. Blythe was born 5 May 1934 in North Carolina to William O. Ezzell
and Alma Richardson. She lived at 1005 Peachtree Avenue, Sedley,
Virginia, worked as a homemaker, and was not a veteran. The attending
physician was E.H. Derring, Jr., M.D.

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|--------------------------------------|-----------------------------------------|
| Field                                | Value                                   |
|--------------------------------------|-----------------------------------------|
| REGISTRATION DISTRICT NUMBER         | 217                                     |
| REGISTER NUMBER                      | 931                                     |
| STATE FILE NUMBER                    | 90-013311                               |
| 1. NAME                              | Alma Ezzell Blythe                      |
| 2. SEX                               | female                                  |
| 3. DATE OF DEATH                     | April 17, 1990                          |
| 4. AGE                               | 55                                      |
| 5a. UNDER 1 YEAR                     | ___ Months ___ Days                     |
| 5b. UNDER 1 DAY                      | ___ Hours ___ Minutes                   |
| 6. DATE OF BIRTH                     | May 5, 1934                             |
| 7. WAS DECEDENT EVER IN U.S. ARMED   | No                                      |
| FORCES?                              | -                                       |
| 8. NAME OF HOSPITAL OR               | Sentara Norfolk General Hosp.           |
| INSTITUTION IF DEATH IN HOSP.        | -                                       |
| 9. IF DEATH OCCURRED OTHER THAN      | ___                                     |
| HOSPITAL/OFFICE                      | -                                       |
| 10. CITY OR TOWN OF DEATH            | Norfolk                                 |
| 11. INSIDE CITY LIMITS?              | Yes                                     |
| 12. COUNTY OF DEATH                  | Norfolk                                 |
| 13. ADDRESS                          | 600 Gresham Drive                       |
| 16. STATE OR FOREIGN COUNTRY         | Virginia                                |
| 17. RESIDENCE: COUNTY                | Southampton County                      |
| 18. CITY, TOWN OR LOCATION           | Sedley                                  |
| 19. ADDRESS                          | 1005 Peachtree Avenue                   |
| 20. ZIP CODE                         | 23878                                   |
| 21. INSIDE CITY LIMITS?              | No                                      |
| 22. NAME OF DECEDENT'S FATHER        | William O. Ezzell                       |
| 23. BIRTHPLACE                       | U.S.A.                                  |
| 24. MAIDEN NAME OF DECEDENT'S MOTHER | Alma Richardson                         |
| 25. BIRTHPLACE                       | NC                                      |
| 26. USUAL OCCUPATION| Homemaker                               |
| 27. KIND OF BUSINESS OR INDUSTRY     | ___                                     |
| 28. EVER MARRIED                     | Yes                                     |
| 29. SPOUSE:                          | Sherman L. Blythe                       |
| 30. INFORMANT OR SOURCE OF           | Sherman L. Blythe                       |
| INFORMATION                          | -                                       |
| 31. RELATIONSHIP TO DECEDENT         | Husband                                 |
| 32. MAILING ADDRESS                  | 1005 Peachtree Avenue, Sedley, VA 23878 |
| 33. EDUCATION                        | Elementary/Secondary (9)                |
| PART I IMMEDIATE CAUSE               | Respiratory Failure                     |
| PART I DUE TO                        | Pulmonary Hemorrhage                    |
| PART II OTHER SIGNIFICANT CONDITIONS | ____                                    |
| INTERVAL BETWEEN ONSET AND DEATH     | Days (b) Hours (c) Minutes              |
| AUTOPSY                              | No                                      |
| PREGNANCY IN PAST 3 MONTHS?          | No                                      |
| IF EXTERNAL CAUSE                    | -                                       |
| PLACE OF INJURY RELATING TO DEATH    | not filled                              |
| OCCURRED                             | -                                       |
| ACTUAL OR PRESUMED DATE OF INJURY    | not filled                              |
| TIME                                 | 10:00 a.m.                              |
| NAME OF ATTENDING PHYSICIAN          | E.H. DERRING, JR., M.D.                 |
| DATE SIGNED                          | 4/17/90                                 |
| PHYSICIAN'S ADDRESS                  | 1205 W. Brambeton Ave., Suite 201,      |
|--                                    | Norfolk, VA 23510                       |
| BURIAL, REMOVAL, CREMATION           | Burial                                  |
| PLACE                                | Southampton Memorial Park, County:      |
|--                                    | Southampton                             |
| FUNERAL DIRECTOR                     | WRIGHT FUNERAL HOME                     |
| ADDRESS                              | 206 W. Fourth Ave., Franklin, VA        |
| SIGNATURE                            | Nellie Trafton                          |
| DATE RECEIVED                        | April 24, 1990                          |
| 34. State No.                        | 013311                                  |
| 33. William B City                   | -                                       |
|--------------------------------------|-----------------------------------------|

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