Death Certificate of Carr, Willie Everson

Willie Everson Carr, son of James A. Carr and Mary Fulham Carr, was born
17 May 1886 in Isle of Wight, Virginia. He died 16 Jun 1957 at DePaul
Hospital, Norfolk, Virginia, from coronary occlusion.

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| ID | Section                      | Field Description                | Value                                 |
|----|------------------------------|----------------------------------|---------------------------------------|
| 1  | PLACE OF DEATH               | County                           | Norfolk                               |
| 2  | PLACE OF DEATH               | City or Town                     | Norfolk                               |
| 3  | PLACE OF DEATH               | Hospital or Institution          | DePaul Hospital                       |
| 4  | PLACE OF DEATH               | Length of Stay                   | D.O.A.                                |
| 5  | USUAL RESIDENCE              | State                            | Virginia                              |
| 6  | USUAL RESIDENCE              | County                           | Norfolk                               |
| 7  | USUAL RESIDENCE              | City or Town                     | Norfolk                               |
| 8  | USUAL RESIDENCE              | Street Address                   | 3128 Kansas Avenue                    |
| 9  | USUAL RESIDENCE              | Is Residence Inside City Limits? | Yes                                   |
| 10 | NAME OF DECEASED             | First                            | Willie                                |
| 11 | NAME OF DECEASED             | Middle                           | Everson                               |
| 12 | NAME OF DECEASED             | Last                             | Carr                                  |
| 13 | SEX                                                             | Male                                  |
| 14 | COLOR OR RACE                                                   | White                                 |
| 15 | MARITAL STATUS                                                  | Married                               |
| 16 | DATE OF BIRTH                                                   | May 17, 1886                          |
| 17 | AGE                                                             | 71 years                              |
| 18 | USUAL OCCUPATION                                                | Railroad                              |
| 19 | KIND OF BUSINESS                                                | Railroad                              |
| 20 | BIRTHPLACE                                                      | Isle of Wight, Va.                    |
| 21 | CITIZEN OF WHAT COUNTRY                                         | U.S.A.                                |
| 22 | FATHER'S NAME                                                   | James A. Carr                         |
| 23 | MOTHER'S MAIDEN NAME                                            | Mary Fulham Carr                      |
| 24 | INFORMANT'S NAME                                                | Rebecca Englien                       |
| 25 | INFORMANT'S ADDRESS                                             | 3128 Kansas Ave., Norfolk, Va.        |
| 26 | IMMEDIATE CAUSE OF DEATH                                        | Coronary occlusion                    |
| 27 | OTHER SIGNIFICANT CONDITIONS                                    | 4201                                  |
| 28 | INTERVAL BETWEEN ONSET/DEATH                                    | Not stated                            |
| 29 | AUTOPSY PERFORMED                                               | No                                    |
| 30 | TIME OF INJURY                                                  | Not stated                            |
| 31 | INJURY OCCURRED                                                 | Not while at work                     |
| 32 | PLACE OF INJURY                                                 | Not stated                            |
| 33 | DATE OF DEATH                                                   | June 16, 1957                         |
| 34 | DATE SIGNED                                                     | 6-18-57                               |
| 35 | PHYSICIAN'S NAME & ADDRESS                                      | L. E. Jones, M.D., 3216 Tidewater Dr. |
| 36 | BURIAL/REMOVAL/CREMATION                                        | Burial                                |
| 37 | DATE OF BURIAL                                                  | June 18, 1957                         |
| 38 | NAME OF CEMETERY/CREMATORY                                      | St. Lukes Cemetery                    |
| 39 | LOCATION OF CEMETERY                                            | Benns Church, Virginia                |
| 40 | FUNERAL DIRECTOR'S SIGNATURE                                    | G. H. Smith                           |
| 41 | FUNERAL DIRECTOR'S NAME                                         | Dey-Twiford Funeral Home              |
| 42 | FUNERAL DIRECTOR'S ADDRESS                                      | 1920 Colley Ave., Norfolk, Va.        |
| 43 | DATE RECEIVED BY LOCAL REG.                                     | 6/19/57                               |
| 44 | REGISTRAR'S SIGNATURE                                           | J. F. Craft                           |
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