Death Certificate of Forrest B. Gilmore

Forrest B. Gilmore, age 45, died of cardiac arrest due to probable
myocardial infarction on 5 Apr 1970 at Norfolk General Hospital,
Norfolk, Virginia. He was born 24 May 1924 in Virginia to William Henry
Gilmore and Lillie May English. He resided at 2506 Lafayette Blvd.,
Norfolk, Virginia, and was married to Rose Marie Waterman. Burial
took place at Forest Lawn Cemetery, Norfolk.

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| Field                                         | Value                                |
|-----------------------------------------------|--------------------------------------|
| REGISTRATION AREA NUMBER                      | 962                                  |
| CERTIFICATE NUMBER                            | 962                                  |
| STATE FILE NUMBER                             | 70 010941                            |
| 1. FULL NAME OF DECEDENT                      | Forrest B. Gilmore                   |
| 2. SEX                                        | Male                                 |
| 3. DATE OF DEATH                              | April 5, 1970                        |
| 4. AGE OF DECEASED                            | 45 years                             |
| 5. NAME OF HOSPITAL OR INSTITUTION            | Norfolk General Hospital             |
| CITY OR TOWN (Place of Death)                 | Norfolk                              |
| COUNTY OF DEATH                               | Norfolk                              |
| ZIP CODE (Place of Death)                     | 23507                                |
| RESIDENCE: STATE                              | Virginia                             |
| RESIDENCE: CITY/TOWN                          | Norfolk                              |
| ADDRESS                                       | 2506 Lafayette Blvd.                 |
| ZIP CODE (Usual Residence)                    | 23509                                |
| FATHER'S NAME                                 | William Henry Gilmore                |
| MOTHER'S MAIDEN NAME                          | Lillie May English                   |
| NAME OF SPOUSE                                | Rose Marie Waterman Gilmore          |
| BIRTHPLACE                                    | Virginia                             |
| DATE OF BIRTH OF DECEASED                     | May 24, 1924                         |
| INFORMANT OR SOURCE                           | Mrs. Rose M. W. Gilmore              |
| 26. CAUSE OF DEATH                            | Cardiac arrest                       |
| 26. CAUSE OF DEATH                            | Probable myocardial infarction       |
| 26. CAUSE OF DEATH                            | 4/09                                 |
| I CERTIFY that I attended the deceased from   | (blank)                              |
| ACTUAL OR PRESUMED TIME OF DEATH              | 12:50                                |
| SIGNATURE OF PHYSICIAN                        | Charles Farquhar, M.D.               |
| ADDRESS (CITY AND STATE)                      | Norfolk, Va.                         |
| DATE SIGNED                                   | 4-8-70                               |
| PLACE OF BURIAL, REMOVAL, OR CREMATION        | Forest Lawn Cemetery, Norfolk, Va.   |
| NAME OF FUNERAL HOME                          | H. D. Oliver Funeral Apts.           |
| FUNERAL DIRECTOR SIGNATURE                    | (blank)                              |
| REGISTRAR SIGNATURE                           | (blank)                              |
| DATE FILED                                    | May 13, 1970                         |
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