Death Certificate of Corbett, George Willard

George Willard Corbett died on 16 Jun 1970 at Veterans Administration
Hospital in Richmond, Virginia at age 50. He was born on 06 Mar 1920 in
Johnston County, North Carolina to George W. Corbett, Sr. and Fida
Deans. The cause of death was pulmonary failure due to pneumonia
resulting from recurrent lung cancer. He was a veteran of World War II
and worked as an Inspector-Maintenance.

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| ID   | Section            | Field Description                       | Value                                  |
|------|--------------------|-----------------------------------------|----------------------------------------|
| 1    | Registration       | Area Number                             | 222-A                                  |
| 2    | Registration       | Certificate Number                      | 2278                                   |
| 3    | Registration       | State File Number                       | 70 017699                              |
| 4    | Decedent           | Full Name                               | George Willard Corbett                 |
| 5    | Decedent           | Date of Death                           | June 16, 1970                          |
| 6    | Decedent           | Age                                     | 50                                     |
| 7    | Decedent           | Sex                                     | Male                                   |
| 8    | Decedent           | Color or Race                           | White                                  |
| 9    | Place of Death     | Name of Hospital or Institution         | Veterans Administration Hospital       |
| 10   | Place of Death     | City or Town                            | Richmond                               |
| 11   | Place of Death     | County                                  | Richmond                               |
| 12   | Place of Death     | Street Address                          | 1201 Broad Rock Road                   |
| 13   | Place of Death     | Zip Code                                | 23219                                  |
| 14   | Usual Residence    | State                                   | North Carolina                         |
| 15   | Usual Residence    | County                                  | Johnston                               |
| 16   | Usual Residence    | City or Town                            | Selma                                  |
| 17   | Usual Residence    | Street Address                          | Route 1                                |
| 18   | Usual Residence    | Zip Code                                | 27576                                  |
| 19   | Personal Data      | Name of Father                          | George W. Corbett, Sr.                 |
| 20   | Personal Data      | Maiden Name of Mother                   | Fadie Deans                            |
| 21   | Personal Data      | Date of Birth                           | 3/6/20                                 |
| 22   | Personal Data      | State or Foreign Country of Birth       | Johnston Co., N.C.                     |
| 23   | Personal Data      | Marital Status                          | Married                                |
| 24   | Personal Data      | Name of Spouse                          | Pauline D. Corbett                     |
| 25   | Personal Data      | Usual Occupation                        | Inspector-Maintenance                  |
| 26   | Personal Data      | Kind of Business or Industry            | C.P. Pickett, VA.                      |
| 27   | Personal Data      | Veteran Status                          | Yes                                    |
| 28   | Personal Data      | War                                     | WW II                                  |
| 29   | Informant          | Name                                    | Pauline D. Corbett                     |
| 30   | Informant          | Mailing Address                         | VA Hospital Records, Richmond, VA.     |
| 31   | Cause of Death     | Immediate Cause (Part I)                | Pulmonary Failure                      |
| 32   | Cause of Death     | Due To                                  | Pneumonia                              |
| 33   | Cause of Death     | Due To                                  | Recurrent Lung Cancer                  |
| 34   | Cause of Death     | Interval Between Onset and Death        | 1621                                   |
| 35   | Cause of Death     | Other Significant Conditions (Part II)  |                                        |
| 36   | Autopsy            | Was Autopsy Performed?                  | Yes                                    |
| 37   | Autopsy            | Autopsy Confirmed Cause?                | Yes                                    |
| 38   | Injury             | Injury at Work?                         | No                                     |
| 39   | Certifier          | Date Signed                             | 6-17-70                                |
| 40   | Certifier          | Physician Name                          | Paul Gusman, M.D.                      |
| 41   | Certifier          | Place Signed                            | VA Hospital, Richmond, VA.             |
| 42   | Certifier          | Date of Death (Certifier)               | 6-16-70                                |
| 43   | Certifier          | Time of Death                           | 7:00                                   |
| 44   | Funeral            | Burial, Removal, or Cremation           | Burial                                 |
| 45   | Funeral            | Place of Burial/Removal/Cremation       | Family Cemetery, Selma, North Carolina |
| 46   | Funeral            | Date of Burial/Removal/Cremation        |                                        |
| 47   | Funeral Director   | Name                                    | Bailey Funeral Home                    |
| 48   | Funeral Director   | Address                                 | Selma, North Carolina                  |
| 49   | Registrar          | Name                                    | V. V. Rhodes                           |
| 50   | Registrar          | Date Received by Registrar              | 6-19-70                                |