Death Certificate of James Robt Gray

James Robt Gray, age 87, died of cancer of prostate on 14 Oct 1953 at
West Nursing Home, Melfa, Virginia. Born 13 Nov 1866 in Virginia to
Benjamin Gray and Martha Barrett, he was widowed and worked as a car
mechanic for railroad. Burial was at Oak Grove, Portsmouth, VA, on 16
Nov 1953.

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| Field                                           | Value                       |
|-------------------------------------------------|-----------------------------|
| 1. PLACE OF DEATH a. County                     | Accomack                    |
| 1. PLACE OF DEATH b. City or Town               | Melfa                       |
| 1. PLACE OF DEATH c. State                      | Virginia                    |
| 1. PLACE OF DEATH d. Registration District No.  | 5D                          |
| 1. PLACE OF DEATH e. Registered No.             | 44                          |
| 1. PLACE OF DEATH f. Inside City Limits         | Yes                         |
| 1. PLACE OF DEATH g. Hospital or Institution    | West Nursing Home           |
| 1. PLACE OF DEATH h. Length of Stay             | (not specified)             |
| 1. PLACE OF DEATH i. Address                    | 2641                        |
| 5. NAME OF DECEASED                             | James Robt Gray             |
| 6. SEX                                          | M                           |
| 7. COLOR OR RACE                                | W                           |
| 8. MARITAL STATUS                               | Widowed                     |
| 9. DATE OF BIRTH                                | 11-13-1866                  |
| 10. AGE                                         | 87                          |
| 12. USUAL OCCUPATION                            | Car Mechanic for Railroad   |
| 13. BIRTHPLACE                                  | Virginia                    |
| 14. FATHER'S NAME                               | Benjamin Gray               |
| 15. MOTHER'S MAIDEN NAME                        | Martha Barrett              |
| 17. INFORMANT'S SIGNATURE                       | Rufus Gray                  |
| 17. INFORMANT'S ADDRESS                         | Portsmouth                  |
| 18. DATE OF DEATH                               | 10-14-53                    |
| 19a. CAUSE OF DEATH                             | Cancer of Prostate          |
| 19a. Interval Between Onset and Death           | 1.5 years                   |
| 19b. OTHER SIGNIFICANT CONDITIONS               | (blank)                     |
| 19b. MAJOR FINDINGS OF OPERATION                | (blank)                     |
| 20. AUTOPSY                                     | No                          |
| 21. ACCIDENT                                    | (blank)                     |
| 21b. PLACE OF INJURY                            | (blank)                     |
| 21c. (CITY, TOWN OR COUNTY)                     | (blank)                     |
| 21d. (STATE)                                    | (blank)                     |
| 21e. INJURY OCCURRED                            | (blank)                     |
| 21f. INJURY AT WORK                             | (blank)                     |
| 22. I hereby certify                            | 1953, 10, 11/14             |
| 22. That I last saw the deceased alive on       | 11/14/53                    |
| 22. And that death occurred at                  | 10-14-53, 11:45 PM          |
| 23a. SIGNATURE OF PHYSICIAN                     | Parker J White              |
| 23c. DATE SIGNED                                | 11/19/53                    |
| 24a. BURIAL, CREMATION, OR REMOVAL              | Burial                      |
| 24b. DATE OF BURIAL                             | 11-16-53                    |
| 24c. NAME OF CEMETERY OR CREMATORY              | Oak Grove                   |
| 24d. LOCATION                                   | Portsmouth                  |
| 25. UNDERTAKER                                  | Carlisle Williams           |
| 25. ADDRESS                                     | Onancock, VA                |
| 26. DATE RECEIVED                               | 11-19-53                    |
| 27. REGISTRAR'S SIGNATURE                       | [illegible]                 |
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