Death Certificate of Cecil Carr

Cecil Carr, age 72, died of cardiac arrest due to arteriosclerotic heart
disease and generalized arteriosclerosis on 23 May 1974 at his
residence, 7975 Carr Lane, Holland Station, Suffolk, Virginia. He was
born 17 Feb 1902 in Virginia to Thomas Jefferson Carr and Dora Bradshaw.
He was married to Daisy Holland Carr. His usual residence was Suffolk,
Virginia.

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| Field                                           | Value                                             |
|-------------------------------------------------|---------------------------------------------------|
| REGISTRATION AREA NUMBER                        | 227                                               |
| CERTIFICATE NUMBER                              | 183                                               |
| STATE FILE NUMBER                               | 74-015451                                         |
| 3. FULL NAME OF DECEASED                        | CRAWLEY CECIL CARR                                |
| 2. SEX                                          | male                                              |
| 3. DATE OF DEATH                                | May 23, 1974                                      |
| 4. AGE OF DECEASED                              | 72 years                                          |
| 5. IF UNDER 1 YEAR                              | (blank)                                           |
| 6. COLOR OR RACE                                | White                                             |
| 6. NAME OF HOSPITAL OR INSTITUTION OF DEATH     | Residence                                         |
| 7. COUNTY OF DEATH                              | Suffolk                                           |
| 8. CITY OR TOWN OF DEATH                        | Suffolk                                           |
| 9. ADDRESS                                      | 7975 Carr Lane, Holland Station                   |
| 10. RESIDENCE: STATE                            | Virginia                                          |
| 11. RESIDENCE: COUNTY                           | Suffolk                                           |
| 12. RESIDENCE: CITY/TOWN                        | Suffolk                                           |
| 13. ADDRESS                                     | 7975 Carr Lane, Holland Sta.                      |
| ZIP CODE                                        | 23437                                             |
| 14. NAME OF FATHER OF DECEASED                  | Thomas Jefferson Carr                             |
| 15. MAIDEN NAME OF MOTHER OF DECEASED           | Dora Bradshaw                                     |
| 16. DECEASED CITIZEN OF WHAT COUNTRY            | USA                                               |
| 17. MARRIED, WIDOWED, DIVORCED, NEVER MARRIED   | Married                                           |
| 18. NAME OF SPOUSE                              | Daisy Holland Carr                                |
| 19. VETERAN                                     | (blank)                                           |
| 20. BIRTHPLACE (State or country)               | Virginia                                          |
| 21. DATE OF BIRTH (month, day, year)            | February 17, 1902                                 |
| 23. USUAL OR LAST OCCUPATION                    | Farmer (ret.)                                     |
| 24. KIND OF BUSINESS OR INDUSTRY                | Farming                                           |
| 25. INFORMANT OR SOURCE OF INFORMATION          | Family                                            |
| 26. CAUSE OF DEATH                              | Cardiac arrest                                    |
| 26. INTERVAL BETWEEN ONSET AND DEATH (A)        | immediate                                         |
| 26. CAUSE OF DEATH                              | Arteriosclerotic heart disease                    |
| 26. INTERVAL BETWEEN ONSET AND DEATH (B)        | 15 yrs                                            |
| 26. CAUSE OF DEATH                              | Generalized arteriosclerosis                      |
| 26. OTHER SIGNIFICANT CONDITIONS                | 4123                                              |
| 26a. AUTOPSY?                                   | No                                                |
| TO PHYSICIAN: DATE OF DEATH                     | 5/23/74                                           |
| TO PHYSICIAN: TIME OF DEATH                     | 5:00 AM                                           |
| TO PHYSICIAN: SIGNATURE OF PHYSICIAN            | (signature present)                               |
| TO PHYSICIAN: DATE SIGNED                       | 5/23/74                                           |
| TO PHYSICIAN: ADDRESS                           | (address present)                                 |
| 28. PLACE OF BURIAL OR REMOVAL                  | Southampton Memorial Park, Southampton Co., Va.   |
| 29. FUNERAL DIRECTOR NAME                       | W.M. Holland & Sons Funeral Home                  |
| 29. ADDRESS OF FUNERAL DIRECTOR                 | Franklin, Virginia 23851                          |
| 29. FUNERAL DIRECTOR SIGNATURE                  | (signature present)                               |
| REGISTRAR: DATE RECEIVED BY REGISTRAR           | 6/4/74                                            |
| REGISTRAR: REGISTRAR SIGNATURE                  | (signature present)                               |
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