Death Certificate of Davidson, John Roland

John Roland Davidson, son of Thomas N. Davidson and Marcie Jones, was
born in Virginia on 3 Jan 1903. He died at Eastern State Hospital,
Williamsburg, Virginia, on 19 Sep 1961, aged 57, from a cerebrovascular
accident.

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|NumericLabel |Section/Field Description                   |Form Data                                              |
|-------------|--------------------------------------------|-------------------------------------------------------|
|1            |Registration Area Number                    |230                                                    |
|2            |Certificate Number                          |234                                                    |
|3            |State File Number                           |23851                                                  |
|4            |Full Name of Deceased                       |John Roland Davidson                                   |
|5            |Date of Death                               |9-19-61                                                |
|6            |Age at Death                                |57 years                                               |
|7            |Sex                                         |Male                                                   |
|8            |Color or Race                               |White                                                  |
|9            |Name of Hospital or Institution             |Eastern State Hospital                                 |
|10           |City or Town of Death                       |Williamsburg, Va.                                      |
|11           |County of Death                             |Williamsburg                                           |
|12           |State of Death                              |Virginia                                               |
|13           |Usual Residence - State                     |Virginia                                               |
|14           |Usual Residence - County                    |Nansemond                                              |
|15           |Usual Residence - City or Town              |Franklin                                               |
|16           |Usual Residence - Street Address or RFD No. |RFD #1                                                 |
|17           |Name of Father of Deceased                  |Thomas N. Davidson                                     |
|18           |Maiden Name of Mother of Deceased           |Marcie Jones                                           |
|19           |Citizen of What Country                     |USA                                                    |
|20           |Marital Status                              |Widowed                                                |
|21           |Name of Spouse                              |Delsie W. Davidson                                     |
|22           |Birthplace of Deceased                      |Virginia                                               |
|23           |Date of Birth of Deceased                   |1-3-03                                                 |
|24           |Veteran                                     |No                                                     |
|25           |Usual Occupation                            |Operator of Mfg. Co.                                   |
|26           |Kind of Business or Industry                |[Blank/Redacted]                                       |
|27           |Informant/Source of Information             |Eastern State Hospital Records, Williamsburg, Virginia |
|28           |Immediate Cause of Death                    |Cerebrovascular accident                               |
|29           |Interval Between Onset and Death            |8 Days                                                 |
|30           |Date of Injury                              |[Blank]                                                |
|31           |Place of Injury                             |[Blank]                                                |
|32           |Autopsy                                     |No                                                     |
|33           |Medical Certification Date Signed           |9-19-61                                                |
|34           |Actual Signature of Certifying Physician    |George B. Massie, M.D.                                 |
|35           |Place of Burial or Removal                  |South Quay Church Cemetery, Nansemond Co., Virginia    |
|36           |Funeral Director                            |Sidney Harrell                                         |
|37           |Date Filed                                  |9-21-61                                                |
|38           |Registrar                                   |Mrs. Jane Brooks                                       |
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