Death Certificate of Gardner, Henry Grady

  
Henry Grady Gardner, age 77, born 15 Jun 1889 in Virginia to John Lawrence Gardner and Sarah Alice March, resided in Gates, North Carolina. He was married to Bessie Howell Gardner. He died on 1 Aug 1967 at Southampton Memorial Hospital, Franklin, Virginia. Cause of death was carcinomatosis due to carcinoma of rectum.

  
--------------------------------------------------------------------------
| Field                                  | Data                          |
|----------------------------------------|-------------------------------|
| Registration Area Number               | 233                           |
| Certificate Number                     | 81                            |
| State File Number                      | 67 021287                     |
| Full Name of Deceased                  | Henry Grady Gardner           |
| Sex                                    | Male                          |
| Date of Death                          | 1 Aug 1967                    |
| Age of Deceased                        | 77                            |
| Color or Race                          | White                         |
| Name of Hospital or Institution        | Southampton Memorial Hospital |
| City or Town of Death                  | Franklin                      |
| County of Death                        | [blank]                       |
| Street Address or Rt. No. of Death     | 700 Fairview Drive            |
| State or Foreign Country of Residence  | North Carolina                |
| County of Residence                    | Nansemond [inconsistent]      |
| City or Town of Residence              | Gates                         |
| Street Address or Rt. No. of Residence | Rt. #2 161                    |
| Name of Father of Deceased             | John Lawrence Gardner         |
| Maiden Name of Mother of Deceased      | Sarah Alice March             |
| Deceased Citizen of What Country       | USA                           |
| Marital Status                         | Married                       |
| Name of Spouse                         | Bessie Howell Gardner         |
| Birthplace of Deceased                 | Virginia                      |
| Date of Birth                          | 15 Jun 1889                   |
| Usual or Last Occupation               | Farmer                        |
| Kind of Business or Industry           | Farming                       |
| Informant or Source of Information     | Hospital Record # S-4293      |
| Immediate Cause of Death               | Carcinomatosis                |
| Due to                                 | Carcinoma of rectum           |
| Interval Between Onset and Death       | 2 yrs, 2 yrs, 154 days        |
| Time of Death                          | 8:00                          |
| Date Signed                            | 2 Aug 1967                    |
| Actual Signature                       | Charles C. Swift              |
| M.D.                                   | Franklin Va                   |
| Burial                                 | Cremation                     |
| Place of Burial                        | [blank]                       |
| Funeral Director                       | Sidney J. Harrell             |
| Name of Funeral Home and Address       | I.O. Hill, Suffolk, Va        |
| Registrar                              | Roberta S. Smith              |
| Date Record Filed                      | 4 Aug 1967                    |
--------------------------------------------------------------------------