Death Certificate of Gray, Charlie Edward

Charlie Edward Gray, age 70, died of apoplexy and senility on 5 Mar 1948
in Southampton County, Virginia. He was born 2 Mar 1878 in Virginia to
Benjamin Gray and Martha Barnett. He was married to Minnie Taylor and
resided in Boykins, Southampton County, Virginia. He was a retired
farmer.

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| Field                                                      | Value                                                                                                                          |
|------------------------------------------------------------|------------------------------------------------------|
| State File No.                                             | 7620                                                 |
| Registered No.                                             | 5                                                    |
| 1. (a) County                                              | Southampton                                          |
| 1. Registration district No.                               | 871a                                                 |
| 1. (b) Magisterial district                                | Boykins                                              |
| 1. (c) City or town                                        | [blank]                                              |
| 1. (d) Name of hospital or institution                     | [blank]                                              |
| 1. (e) Length of stay in hosp. or inst.                    | [blank]                                              |
| 1. In this community                                       | [blank]                                              |
| 1. (f) Is place of death within corporate limits?          | no                                                   |
| 2. (a) State                                               | Va.                                                  |
| 2. (b) County                                              | Southampton                                          |
| 2. (c) City or town                                        | Boykins                                              |
| 2. Street No.                                              | R F D                                                |
| 2. (d) Is place of residence (within corporate limits)?    | no                                                   |
| 2. (e) Citizen of foreign country?                         | [blank]                                              |
| 3. (a) FULL NAME                                           | Charlie Edward Gray                                  |
| 3. (b) VETERAN                                             | [blank]                                              |
| 4. Sex                                                     | Male                                                 |
| 5. Color or race                                           | White                                                |
| 6. (a) Single, married, widowed, divorced                  | Married                                              |
| 6. (b) Name of husband or wife                             | Minnie Taylor                                        |
| 7. Date of birth of deceased                               | March 2 1878                                         |
| 8. Age - Years                                             | 70                                                   |
| 8. Age - Months                                            | 6                                                    |
| 8. Age - Days                                              | 3                                                    |
| 8. If less than one day hours min                          | [blank]                                              |
| 9. Birthplace                                              | Va.                                                  |
| 10. Usual occupation                                       | Retired farmer                                       |
| 11. INDUSTRY OR BUSINESS?                                  | [blank]                                              |
| 12. Name (Father)                                          | Benjamin Gray                                        |
| 13. Birthplace (Father)                                    | Va.                                                  |
| 14. Maiden name (Mother)                                   | Martha Barnett                                       |
| 15. Birthplace (Mother)                                    | Va.                                                  |
| 16. (a) Informant’s own signature                          | Mrs. Jack Smith                                      |
| 16. (b) Address                                            | Boykins, Va.                                         |
| 17. (a) Burial, cremation, or removal?                     | Burial                                               |
| 17. (b) Place                                              | Beckford                                             |
| 17. Date                                                   | March 6 1948                                         |
| 18. (a) FUNERAL DIRECTOR SIGNATURE                         | H. L. Providence & Sons                              |
| 18. (b) Address                                            | Boykins, Va.                                         |
| 19. (a) Filed                                              | 3/10 48                                              |
| 19. (b)                                                    | Mrs. W. P. Maurer                                    |
| 20. Date of death                                          | March 5 1948 at 1:45 a.m.                            |
| 21. I hereby certify                                       | Feb 1 1948 to March 5 1948, I last saw Mar 3 1948    |
| Immediate cause of death                                   | Apoplexy & senility                                  |
| Duration                                                   | 2 weeks                                              |
| Due to                                                     | [blank]                                              |
| Due to Other conditions                                    | 083A                                                 |
| Name of operation                                          | [blank]                                              |
| Date of operation                                          | [blank]                                              |
| Major findings: (a) of operations                          | [blank]                                              |
| Major findings: (b) of autopsy                             | [blank]                                              |
| 22. (a) Accident, suicide, or homicide (specify)           | [blank]                                              |
| 22. (b) Date of occurrence                                 | [blank]                                              |
| 22. (c) Where did injury occur?                            | [blank]                                              |
| 22. While at work?                                         | [blank]                                              |
| 22. (e) Means of injury                                    | [blank]                                              |
| 23. Signature                                              | J. J. Buzzard M.D. Cor.                              |
| 23. Address                                                | J. Buzzard M.D.                                      |
| 23. Date signed                                            | 3-10-48                                              |
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