Death Certificate of James H Carr

James H. Carr, 47, died on 15 May 1917 in Nansemond County from
pneumonia and pericarditis due to tobacco heart. He was buried on 16 May
1917 at Beaverdam Church.

Mr. Carr was born on 14 Feb 1870 in Isle of Wight County, the son of
Jno. H. Carr and Pennie English. He was single, worked as a farmer and
fruit tree seller, and resided in Holland, Virginia. Informant was L.
Blythe.

|-----------------------------------------------------------------------------------------------|
| Field                                            | Value                                      |
|--------------------------------------------------|--------------------------------------------|
| Form No. 12.                                     | -                                          |
| CERTIFICATE OF DEATH                             | -                                          |
| File No.                                         | 12481                                      |
| Registered No.                                   | 15                                         |
| 1. County                                        | Nansemond                                  |
| 1. District                                      | Holy Neck                                  |
| 2. FULL NAME                                     | James H. Carr                              |
| 3 SEX                                            | Male                                       |
| 4 COLOR OR RACE                                  | White                                      |
| 5 SINGLE, MARRIED, WIDOWED, OR DIVORCED          | Single                                     |
| 6 DATE OF BIRTH                                  | Feby 14 1870                               |
| 7 AGE                                            | 47 yrs 3 mos 0 ds                          |
| 8 OCCUPATION                                     | Selling fruit trees, Farmer                |
| 9 BIRTHPLACE (State or Country)                  | Isle of Wight Co.                          |
| 10 NAME OF FATHER                                | Jno. H. Carr                               |
| 11 BIRTHPLACE OF FATHER                          | Isle of Wight                              |
| 12 MAIDEN NAME OF MOTHER                         | Pennie English                             |
| 13 BIRTHPLACE OF MOTHER                          | Isle of Wight Co.                          |
| 14 THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE | L. Blythe                                  |
| 14 Address                                       | Holland, Va.                               |
| J5 Filed                                         | May 23, 1917                               |
| J5 Signed                                        | Jos. Holland, LOCAL REGISTRAR              |
| 16 DATE OF DEATH                                 | May 15th 1917                              |
| 17 I HEREBY CERTIFY                              | Attended deceased from May 12, 1917, to    |
|--                                                | May 15, 1917; last saw alive May 14, 1917; |
|--                                                | death occurred 2 p.m.                      |
| 17 CAUSE OF DEATH                                | Pneumonia & pericarditis                   |
| 17 Contributory                                  | Tobacco Heart                              |
| 17 Duration                                      | 2 yrs. 0 mos. 0 ds.                        |
| 17 Signed                                        | John Holland M.D.                          |
| 17 Date                                          | 5-16 1917                                  |
| 17 Address                                       | Holland, Va.                               |
| 18 Length of residence                           | --                                         |
| 19 PLACE OF BURIAL OR REMOVAL                    | Beaverdam Church                           |
| 19 DATE OF BURIAL                                | May 16, 1917                               |
| 19 UNDERTAKER                                    | S.W. Holland                               |
| 19 Address                                       | Holland, Va.                               |
|-----------------------------------------------------------------------------------------------|

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