Death Certificate of Jacob Thomas Bradshaw

Jacob Thomas Bradshaw, age 88, died from arteriosclerosis on 31 Jul 1929
in Isle of Wight County, Virginia, residing at Windsor Magisterial
District. He was born 17 Apr 1841 in Isle if Wight Co., Virginia, to
Joseph Bradshaw and Annie Beale. He was married to Nannie V. Bradshaw. A
farmer by occupation, he was buried at Beaver Dam Church on 3 Aug 1929.

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| Field                                               | Value                                      |
|-----------------------------------------------------|--------------------------------------------|
| 1. PLACE OF DEATH                                   | County of Isle of Wight, Windsor           |
| 2. FULL NAME                                        | Jacob Thomas Bradshaw                      |
| SEX                                                 | Male                                       |
| COLOR OR RACE                                       | White                                      |
| (3) Single, Married, Widowed, or Divorced           | Married                                    |
| Husband of (or) Wife of                             | Nannie V. Bradshaw                         |
| 7. DATE OF BIRTH                                    | 1841 Apr 17                                |
| 8. AGE                                              | Years 88| Months 3| Days 14                |
| 9. OCCUPATION OF DECEASED                           | Farmer                                     |
| 10. Name of Employer                                | Isle of Wight Co. Va.                      |
| BIRTHPLACE                                          | Isle of Wight Co. Va.                      |
| 10. NAME OF FATHER                                  | Joseph Bradshaw                            |
| 11. BIRTHPLACE OF FATHER                            | Isle of Wight Co. Va.                      |
| 12. MAIDEN NAME OF MOTHER                           | Annie Beale                                |
| 13. BIRTHPLACE OF MOTHER                            | Isle of Wight Co. Va.                      |
| 14. INFORMANT                                       | C. J. Bradshaw                             |
| (Address)                                           | Carrsville, Va.                            |
| 16. DATE OF DEATH                                   | 1929 July 31                               |
| 17. I ATTENDED DECEASED FROM                        | 1929 July 3 1 to 1929 July 31              |
| That I last saw him alive on                        | 1929 July 31                               |
| And that death occurred, on date stated above, at   | 4 P.M.                                     |
| The CAUSE OF DEATH                                  | Arterio Sclerosis (DURATION): 2 yrs        |
| Contributory (Secondary)                            | (blank)                                    |
| 18. WHERE WAS DISEASE CONTRACTED?                   | (Blank)                                    |
| Did an operation precede death?                     | No                                         |
| Date of                                             | (Blank)                                    |
| Was there an autopsy?                               | No                                         |
| What test confirmed diagnosis?                      | (Blank)                                    |
| Signed                                              | C. J. Bradshaw, M.D.                       |
| (Address)                                           | Carrsville, Va.                            |
| Date signed                                         | Aug. 3, 1929                               |
| 19. PLACE OF BURIAL, CREMATION, OR REMOVAL          | Beaver Dam Church                          |
| DATE OF BURIAL                                      | Aug. 3, 1929                               |
| 20. UNDERTAKER                                      | W J M Holland and Son                      |
| (ADDRESS)                                           | Woodway, Va.                               |
| Registrar                                           | Ethel L. Davis                             |
| Date Filed                                          | May 20 1930                                |
| Registered No.                                      | 17                                         |
| Registration District No.                           | 462                                        |
| Local Registrar's No.                               | 31310                                      |
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