Death Certificate of Fowler, William Benton

William Benton Fowler, age 39, died of congestive heart failure due to
hypertensive cardiovascular disease on 20 Feb 1959 at Raiford Memorial
Hospital, Franklin, Southampton County, Virginia. He was born 30 Oct
1919 in Virginia to Hersey N. Fowler and Ruth Snipes, was married, and
lived on Camp Lane, Franklin, Isle of Wight County, Virginia. Pulmonary
emphysema contributed to his death.

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| Field                                        | Value                                |
|----------------------------------------------|--------------------------------------|
| Registration No.                             | 2874                                 |
| District No.                                 | 22                                   |
| Registered No.                               | 22                                   |
| State File No.                               | 50582                                |
| 1. PLACE OF DEATH a. COUNTY                  | Southampton                          |
| 1. PLACE OF DEATH b. CITY OR TOWN            | Franklin                             |
| 1. PLACE OF DEATH c. HOSPITAL OR INSTITUTION | Raiford Memorial Hospital            |
| 1. PLACE OF DEATH d. LENGTH OF STAY          | [blank]                              |
| 2. USUAL RESIDENCE a. STATE                  | Virginia                             |
| 2. USUAL RESIDENCE b. COUNTY                 | Isle of Wight                        |
| 2. USUAL RESIDENCE c. CITY OR TOWN           | Franklin                             |
| 2. USUAL RESIDENCE d. ADDRESS                | Camp Lane                            |
| 2. USUAL RESIDENCE e. INSIDE CITY LIMITS     | Yes                                  |
| 3. NAME OF DECEASED                          | William Benton Fowler                |
| 4. DATE OF DEATH                             | Feb. 20th, 1959                      |
| 5. SEX                                       | Male                                 |
| 6. COLOR OR RACE                             | White                                |
| 7. MARITAL STATUS                            | Married                              |
| 8. DATE OF BIRTH                             | Oct. 30th, 1919                      |
| 9. AGE                                       | 39 years                             |
| 10. USUAL OCCUPATION                         | Lumber Stamper (Retired)             |
| 11. KIND OF BUSINESS OR INDUSTRY             | Lumber                               |
| 12. BIRTHPLACE                               | Virginia                             |
| 13. CITIZENSHIP                              | U.S.A.                               |
| 14. FATHER'S NAME                            | Hersey N. Fowler                     |
| 15. MOTHER'S MAIDEN NAME                     | Ruth Snipes                          |
| 17. INFORMANT'S SIGNATURE                    | Mrs. Hersey Fowler                   |
| 17. INFORMANT'S ADDRESS                      | Franklin, Virginia                   |
| 18. CAUSE OF DEATH                           | Congestive Heart Failure             |
| 18. CAUSE OF DEATH                           | Hypertensive Cardiovascular disease  |
| 18. OTHER SIGNIFICANT CONDITIONS             | Pulmonary Emphysema                  |
| 18. INTERVAL BETWEEN ONSET AND DEATH         | ?                                    |
| 19. WAS AUTOPSY PERFORMED?                   | No                                   |
| 20a. ACCIDENT, SUICIDE, HOMICIDE             | [blank]                              |
| 20b. DESCRIBE HOW INJURY OCCURRED            | [blank]                              |
| 20c. DATE OF INJURY                          | [blank]                              |
| 20d. INJURY OCCURRED AT                      | [blank]                              |
| 20e. PLACE OF INJURY                         | [blank]                              |
| 20f. CITY, TOWN, OR LOCATION                 | [blank]                              |
| 20g. COUNTY                                  | [blank]                              |
| 20h. STATE                                   | [blank]                              |
| 21. I attended the deceased from             | 2-20-1959                            |
| 21. Death occurred at                        | 11:30                                |
| 22a. SIGNATURE                               | M. Lambdin, M.D.                     |
| 22b. ADDRESS                                 | Franklin, Virginia                   |
| 22c. DATE SIGNED                             | 2-24-59                              |
| 23a. BURIAL, CREMATION, REMOVAL              | Burial                               |
| 23b. DATE                                    | Feb. 23, 1959                        |
| 23c. NAME OF CEMETERY OR CREMATORY           | Poplar Spring Cemetery               |
| 23d. LOCATION                                | Franklin                             |
| 23e. (State)                                 | Virginia                             |
| 24. FUNERAL DIRECTOR'S SIGNATURE             | W.J.M. Holland & Sons                |
| 24. ADDRESS                                  | Franklin, Virginia                   |
| DATE REC'D BY LOCAL REG.                     | Feb. 1959 Rept.                      |
| REGISTRAR'S SIGNATURE                        | Mrs. J. H. Canady                    |
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