Death Certificate of Drake, Fannie

Mrs. Fannie Drake died at Newsoms, Southampton Co., Va, on 5 Mar 1926,
aged 74. She was married to W. T. Drake. Her cause of death was broncho
pneumonia. She was born on 4 Oct 1851 in Southampton Co., Va, to Giles
E. Vick and Louise Bunn. Her residence was Newsoms, Va.

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| Field                                                                | Value                                                                                                       |
|----------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------|
| 1 PLACE OF DEATH                                                     | County: SouthamptonMagisterial District: Newsoms                                                            |
| 2 FULL NAME                                                          | Mrs. Fannie Drake                                                                                           |
| (a) Residence. No.                                                   | [No value written]                                                                                          |
| PERSONAL AND STATISTICAL PARTICULARS                                                                                                                                               |
| 3 SEX                                                                | Female                                                                                                      |
| 4 COLOR OR RACE                                                      | White                                                                                                       |
| 5 Single, Married, Widowed, or Divorced                              | Married                                                                                                     |
| 5a SPOUSE:                                                           | Wife of W. T. Drake                                                                                         |
| 6 DATE OF BIRTH (MONTH, DAY, AND YEAR, WRITE NAME OF MONTH)          | Oct. 4, 1851                                                                                                |
| 7 AGE                                                                | 74                                                                                                          |
| 8 OCCUPATION OF DECEASED                                             | House keeper                                                                                                |
| (a) TRADE, PROFESSION, ETC?                                          | House keeper                                                                                                |
| (b) GENERAL NATURE OF EMPLOYMent (OR EMPLOYER)                       | [No value written]                                                                                          |
| (c) NAME OF EMPLOYER                                                 | [No value written]                                                                                          |
| 9 BIRTHPLACE                                                         | Southampton Co., Va                                                                                         |
|                                                                      | [No value written]                                                                                          |                                                          |                                                          |
| (STATE OR COUNTRY)                                                   | Va                                                                                                          |                                                          |                                                          |
| 10 NAME OF FATHER                                                    | Giles E. Vick                                                                                               |
| 11 BIRTHPLACE OF FATHER                                              | Southampton Co.                                                                                             |
|                                                                      | [No value written]                                                                                          |                                                          |                                                          |
| (STATE OR COUNTRY)                                                   | Va                                                                                                          |                                                          |                                                          |
| 12 MAIDEN NAME OF MOTHER                                             | Louise Bunn                                                                                                 |
| 13 BIRTHPLACE OF MOTHER                                              | Southampton Co.                                                                                             |
|                                                                      | [No value written]                                                                                          |                                                          |                                                          |
| (STATE OR COUNTRY)                                                   | Va                                                                                                          |                                                          |                                                          |
| 14 INFORMANT                                                         | W. Wesley Vick                                                                                              |
| (ADDRESS)                                                            | Newsoms, Va                                                                                                 |
| 15 FILED                                                             | March 6, 1926, Aston Bryant (Registrar)                                                                     |
| MEDICAL CERTIFICATE OF DEATH                                                                                                                                                       |
| 16 DATE OF DEATH (MONTH, DAY, AND YEAR, WRITE NAME OF MONTH)         | March 5, 1926                                                                                               |
| 17 I HEREBY CERTIFY, THAT I ATTENDED DECEASED FROM ___ TO ___, THAT                                                                                                                |
| I LAST SAW ALIVE:                                                    | ON ___, AND THAT DEATH OCCURRED ON THE DATE STATED ABOVE, AT ___ M.  | From March 5, 1926 to March 5, 1926. |
| Last saw alive:                                                      | March 5, 1926. Death occurred March 5, 1926 at 6 PM.                                                        |
| THE CAUSE OF DEATH* WAS AS FOLLOWS:                                  | Broncho Pneumonia                                                                                           |
| (DURATION)                                                           | Yrs: [blank] Mos: [blank] Ds: 14                                                                            |
| CONTRIBUTORY (SECONDARY)                                             | Brief                                                                                                       |
| (DURATION)                                                           | [blank]                                                                                                     |
| 18 WHERE WAS DISEASE CONTRACTED IF NOT AT PLACE OF DEATH?            | [No value written]                                                                                          |
| DID AN OPERATION PRECEDE DEATH? ___ DATE OF ___                      | [No value written]                                                                                          |
| WAS THERE AN AUTOPSY? ___                                            | No                                                                                                          |
| WHAT TEST CONFIRMED DIAGNOSIS? ___                                   | Symptoms                                                                                                    |
| (SIGNED)                                                             | B. J. Pope, M.D.                                                                                            |
| (ADDRESS)                                                            | Boykins, Va                                                                                                 |
| DATE                                                                 | 3/6/1926 (Assess)                                                                                           |
| PLACE OF BURIAL, CREMATION, OR REMOVAL                               | Newsoms                                                                                                     |
| DATE OF BURIAL                                                       | 3/7/26                                                                                                      |
| 20 UNDERTAKER                                                        | W. J. Holland                                                                                               |
| ADDRESS                                                              | Franklin, Va                                                                                                |
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