Death Certificate of James Hutson Ford

James Hutson Ford, 55, died on 20 Sep 1959 in Richmond Va. from hepatic
coma, shock, aspiration food due to bleeding esophageal varices. A
resident of 1634 Glenfield Ave, he was married to Thelma Lane and was
buried on 22 Sep 1959 at Riverview, Richmond Va.

Mr. Ford, son of Hutson Spottswood Ford and Hallie Farrell, was a white
male born in Henrico Co Va on 7 Nov 1903. He worked as a produce
salesman. Death was certified by H. J. Conquest, M.D. at Medical College
of Va Hospital after a 20-day stay.

|--------------------------------------------|-------------------------------------------|
| Field                                      | Value                                     |
|--------------------------------------------|-------------------------------------------|
| Registration District No.                  | 5810                                      |
| Certificate No.                            | 22563                                     |
| A. COUNTY                                  | -                                         |
| B. CITY OR TOWN                            | Richmond Va.                              |
| C. HOSPITAL OR INSTITUTION                 | Medical College of Va Hospital 20 Days    |
| 1A. STATE                                  | Virginia                                  |
| 1B. COUNTY                                 | -                                         |
| 1C. CITY OR TOWN                           | Richmond                                  |
| 1D. ADDRESS                                | 1634 Glenfield Ave                        |
| 1E. IS RESIDENCE INSIDE CITY OR TOWN?      | YES                                       |
| 1F. IS RESIDENCE ON A FARM?                | NO                                        |
| 2. FULL NAME OF DECEASED                   | James Hutson Ford                         |
| 3. SEX                                     | Male                                      |
| 4. COLOR OR RACE                           | White                                     |
| 5. MARITAL STATUS                          | Married                                   |
| 6. DATE OF BIRTH                           | Nov 7 1903                                |
| 7. AGE                                     | 55 Years                                  |
| 8. USUAL OCCUPATION                        | Produce Salesman                          |
| 9. KIND OF BUSINESS OR INDUSTRY            | -                                         |
| 10. BIRTHPLACE                             | Henrico Co Va                             |
| 11. CITIZEN OF WHAT COUNTRY                | U.S.A.                                    |
| 12. FATHER'S NAME                          | Hutson Spottswood Ford                    |
| 13. MOTHER'S MAIDEN NAME                   | Hallie Farrell                            |
| 14. INFORMANT'S SIGNATURE                  | Mrs. Hallie Ford                          |
| 14. ADDRESS                                | 1634 Glenfield Ave                        |
| 15. WAS THE DECEASED IN U.S. ARMED FORCES? | -                                         |
| 16. SPOUSE:                                | Thelma Lane                               |
| 17. DATE OF DEATH                          | Sept 20 1959                              |
| 18. IMMEDIATE CAUSE                        | Hepatic coma, shock, aspiration food      |
| 18. INTERVAL BETWEEN ONSET AND DEATH       | 581.0                                     |
| 18. DUE TO                                 | Bleeding esophageal varices               |
| 18. INTERVAL                               | 1 day                                     |
| 18. DUE TO                                 | Laennec's Cirrhosis - Portal Hypertension |
| 18. INTERVAL                               | -                                         |
| 18. PART II: OTHER CONDITIONS              | -                                         |
| 19. WAS AUTOPSY PERFORMED?                 | NO                                        |
| 20. ACCIDENT SUICIDE HOMICIDE              | -                                         |
| 20a. DESCRIBE HOW INJURY OCCURRED          | -                                         |
| 20b. TIME OF INJURY                        | -                                         |
| 20c. PLACE OF INJURY                       | -                                         |
| 20d. INJURY OCCURRED                       | NOT WHILE AT WORK                         |
| 21. ATTENDING PHYSICIAN from               | 9-10-59                                   |
| 21. to                                     | 9-20-59                                   |
| 21. LAST SAW ALIVE                         | 9-20-59                                   |
| 21. DEATH OCCURRED AT                      | 9:15 AM                                   |
| SIGNATURE                                  | H. J. Conquest, M.D.                      |
| DATE SIGNED                                | 9/21/59                                   |
| 22. DATE REMOVAL                           | -                                         |
| 23a. BURIAL, CREMATION, REMOVAL            | Burial                                    |
| 23b. DATE                                  | Sept. 22, 1959                            |
| 23c. NAME OF CEMETERY OR CREMATORY     s    | Riverview                                 |
| 23d. LOCATION                              | Richmond Va.                              |
| FUNERAL DIRECTOR'S SIGNATURE               | Joseph W. Bliley Co                       |
| FUNERAL DIRECTOR'S ADDRESS                 | Richmond, Va.                             |
| DATE FILED BY LOCAL REG.                   | SEP 21 1959                               |
| REGISTRAR'S SIGNATURE                      | D. B. Harwood                             |
| STATE REGISTRAR'S SIGNATURE                | Joseph W. Hillery                         |
|--------------------------------------------|-------------------------------------------|

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