Death Certificate of Coates, Jessie Varnell Mayes


Jessie Varnell Mayes Coates, age 79, was born 19 May 1917 in Halifax
County, North Carolina to Roberto O. Mayes Sr. and Maude Keeter. She
resided in Roanoke Rapids, NC. She died 13 October 1996 at Southside
Regional Medical Center, Petersburg, Virginia. She was widowed, spouse
Ralph E. Coates. Cause of death was sepsis due to urinary tract
infection and immobility.

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| Field                            | Value                                                 |
|----------------------------------|-------------------------------------------------------|
| Full Name of Decedent            | Jessie Varnell Mayes Coates                           |
| Sex                              | Female                                                |
| Date of Death                    | 13 October 1996                                       |
| Age at Death                     | 79                                                    |
| Date of Birth                    | 19 May 1917                                           |
| Place of Death                   | Southside Regional Med. Center, Petersburg, VA        |
| Usual Residence                  | 811 E. 12th St., Roanoke Rapids, Halifax Co., NC27870 |
| Father's Name                    | Roberto O. Mayes Sr.                                  |
| Mother's Maiden Name             | Maude Keeter                                          |
| Race                             | White                                                 |
| Education                        | 9th grade                                             |
| Birthplace                       | Halifax Co., North Carolina, U.S.A.                   |
| Usual Occupation                 | Spinner                                               |
| Kind of Business/Industry        | Textiles                                              |
| Marital Status                   | Widowed                                               |
| Name of Spouse                   | Ralph E. Coates                                       |
| Informant                        | Deloris M. Ellis                                      |
| Immediate Cause of Death         | Sepsis                                                |
| Interval between onset and death | 3 days                                                |
| Due to/Consequent of             | Urinary Tract Infection (3 days)                      |
| Due to/Consequent of             | Immobility (3 months)                                 |
| Other Significant Conditions     | Generalized debility                                  |
| Autopsy                          | No                                                    |
| Place of Injury                  | None                                                  |
| Manner of Death                  | Natural                                               |
| Attending Physician              | Smith, M.D.                                           |
| Date Signed                      | 14 October 1996                                       |
| Address of Attending Physician   | South Hill, VA 23970                                  |
| Method of Disposition            | Burial                                                |
| Place of Burial                  | Cedarwood Cemetery, Roanoke Rapids, N.C.              |
| Funeral Director                 | Hockaday                                              |
| Funeral Home Address             | Hockaday - Roanoke Rapids, N.C.                       |
| Registrar                        | Leonard Hedgepeth                                     |
| Date Received by Registrar       | 31 October 1996                                       |
| State File Number                | 96-041608                                             |
| Certificate Number               | 570                                                   |
| Area Number                      | 219                                                   |
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