Death Certificate of Hattie Lee Fowler

Hattie Lee Fowler, 78, died on 2 Feb 1985 in Fredericksburg from cardiac
and respiratory arrest due to staphacemia. A resident of Fredericksburg,
she was never married and was cremated and was buried at Forest Lawn 
Crematory, Richmond, Virginia.

Mrs. Fowler suffered from diabetes mellitus and uremia. She resided at
120 Kings Hwy, Fredericksburg, Stafford County, Virginia. Her parents
were Charlie Fowler and Mary Virginia Duck. The informant was Mrs.
Mattie Sitek.

|-------------------------------------------------------------------------------------|
| Field                                      | Value                                  |
|--------------------------------------------|----------------------------------------|
| CERTIFICATE NUMBER                         | 85-004070                              |
| REGISTRATION AREA NUMBER                   | 209                                    |
| REGISTER NUMBER                            | 49                                     |
| first                                      | Hattie                                 |
| middle                                     | Lee                                    |
| last                                       | Fowler                                 |
| DATE OF DEATH                              | February 2, 1985                       |
| AGE                                        | 78                                     |
| SEX                                        | F                                      |
| RACE                                       | Caucasian                              |
| DATE OF BIRTH                              | Jan. 1, 1907                           |
| NAME OF HOSPITAL OR INSTITUTION            | Mary Washington Hospital               |
| CITY OR TOWN OF DEATH                      | Fredericksburg                         |
| 189 5                                      | -                                      |
| RESIDENCE: STATE                           | Virginia                               |
| RESIDENCE: CITY/TOWN                       | Fredericksburg                         |
| RESIDENCE: COUNTY                          | Stafford                               |
| ADDRESS                                    | 2300 Fall Hill Avenue                  |
| ZIP CODE                                   | 22405                                  |
| 54 7                                       | -                                      |
| NAME OF FATHER OF DECEDENT                 | Charlie Fowler                         |
| MAIDEN NAME OF MOTHER OF DECEDENT          | Mary Virginia Duck                     |
| CITIZEN OF WHAT COUNTRY                    | U.S.A.                                 |
| BIRTHPLACE                                 | Virginia                               |
| ADDRESS                                    | 120 Kings Hwy.                         |
| ZIP CODE                                   | 22405                                  |
| NEVER MARRIED                              | box checked                            |
| DIVORCED                                   | box unchecked                          |
| WIDOWED                                    | box unchecked                          |
| SPOUSE                                     | None                                   |
| USUAL OR LAST OCCUPATION                   | None                                   |
| KIND OF BUSINESS OR INDUSTRY               | None                                   |
| INFORMANT OR SOURCE OF INFORMATION         | Mrs. Mattie Sitek                      |
| IMMEDIATE CAUSE                            | Cardiac and respiratory arrest         |
| DUE TO                                     | Staphacemia                            |
| DUE TO                                     | Hepatic stenosis (10 days)             |
| DUE TO                                     | Congestive cardiac failure (100 days)  |
| OTHER SIGNIFICANT CONDITIONS               | Uremia                                 |
| PART II (OTHER SIGNIFICANT CONDITIONS)     | Diabetes Mellitus                      |
| INTERVAL BETWEEN ONSET AND DEATH           | 2                                      |
| AUTOPSY                                    | No                                     |
| PHYSICIAN: To the best of my knowledge,    | death occurred at 8:10 a.m.            |
| SIGNATURE AND TITLE OF ATTENDING PHYSICIAN | Angus Macarak, M.D.                    |
| DATE SIGNED                                | 2/4/85                                 |
| ADDRESS OF ATTENDING PHYSICIAN             | 1300 Thornton Ave. Fredericksburg Va   |
| FUNERAL DIRECTOR                           | Allen H. DeSchon                       |
| PLACE OF BURIAL, REMOVAL, CREMATION        | Forest Lawn Crematory, Richmond, Virgin|
| NAME OF FUNERAL HOME                       | Wheeler & Thompson, Inc.               |
| ADDRESS                                    | Fredericksburg, Virginia               |
| REGISTRAR                                  | Linda H Mitts                          |
| DATE RECEIVED                              | 2-5-85                                 |
|-------------------------------------------------------------------------------------|

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