Death Certificate of Catherine Beale Gwaltney

            
Ms. Gwaltney was born on 16 Sep 1918 in Virginia, daughter of Hugh
Patrick Beale and Berta Helens. Her race was recorded as Caucasian and
she was a retired realtor. Her residence and place of death was 102
Gatewood Ave., Suffolk.

|--------------------------------------------|---------------------------------------|
| Field                                      | Value                                 |
|--------------------------------------------|---------------------------------------|
| REGISTRATION AREA NUMBER                   | 227                                   |
| CERTIFICATE NUMBER                         | 629                                   |
| STATE FILE NUMBER                          | 98:051789                             |
| 1. FULL NAME OF DECEDENT                   | Catherine Beale Gwaltney               |
| 2. DATE OF DEATH                           | December 19, 1998                     |
| 3. AGE                                     | 80                                    |
| 4. SEX                                     | F                                     |
| 5. IF UNDER 1 YEAR                         | months ___ days ___                   |
| 6. IF UNDER 1 DAY                          | hours ___ minutes ___                 |
| 7. DATE OF BIRTH                           | September 16, 1918                    |
| 8. WAS DECEDENT EVER IN U.S. ARMED FORCES? | No [checked]                          |
| 9. COUNTY OF DEATH                         |                                       |
| 10. NAME OF HOSPITAL OR INSTITUTION        | None                                  |
| 11. CITY OR TOWN OF DEATH                  | Suffolk                               |
| 12. INSIDE CITY LIMITS?                    | Yes [checked]                         |
| 13. ADDRESS                                | 102 Gatewood Ave.                     |
| 14. ZIP CODE                               | 23434                                 |
| 15. RESIDENCE: STATE                       | Virginia                              |
| 16. RESIDENCE: COUNTY                      | XX [checked]                          |
| 17. RESIDENCE: CITY/TOWN                   | Suffolk                               |
| 18. INSIDE CITY LIMITS?                    | Yes [checked]                         |
| 19. ADDRESS                                | 102 Gatewood Ave.                     |
| 20. ZIP CODE                               | 23434                                 |
| 21. NAME OF DECEDENT'S FATHER              | Hugh Patrick Beale                    |
| 22. RACE OF DECEDENT                       | Caucasian XX [checked]                |
| 23. CITIZEN OF WHAT COUNTRY                | U.S.A.                                |
| 24. BIRTHPLACE                             | Virginia                              |
| 25. SOCIAL SECURITY NUMBER                 | -                                     |
| 26. USUAL OCCUPATION                       | Retired Realtor Brent Realty          |
| 27. KIND OF BUSINESS OR INDUSTRY           | Hayden G. Constance                   |
| 28. EDUCATION                              | College (1 of 4 or 5): 1              |
| 29. MARITAL STATUS                         | WIDOWED XX [checked]                  |
| 30. NAME OF SPOUSE                         | -                                     |
| 31. MAIDEN NAME OF DECEDENT'S MOTHER       | Berta Helens                          |
| 32. IMMEDIATE CAUSE                        | Hypertensive cardiovascular disease   |
| 33. DUE TO                                 | -                                     |
| 34. PART II. OTHER SIGNIFICANT CONDITIONS  | -                                     |
| 35. INTERVAL BETWEEN ONSET AND DEATH       | -                                     |
| 36. PREGNANCY IN PAST 3 MONTHS?            | No XX [checked]                       |
| 37. EXTERNAL CAUSE                         | Accident [ ] Suicide [ ] Homicide [ ] |
| 38. DESCRIBE HOW INJURY RELATING TO DEATH  | -                                     |
| 39. PLACE OF INJURY                        | -                                     |
| 40. COUNTY                                 | -                                     |
| 41. CITY OR TOWN                           | -                                     |
| 42. AT THE TIME OF MY KNOWLEDGE, DEATH     | -                                     |
| 43. ACTUAL OR PRESUMED TIME OF DEATH       | -                                     |
| 44. DATE SIGNED                            | 12-22-98                              |
| 45. SIGNATURE OF ATTENDING PHYSICIAN       | J.L. Verdirame MD                     |
| 46. ADDRESS OF ATTENDING PHYSICIAN         | 2000 Meade Parkway, Suffolk, VA       |
| BURIAL                                     | XX [checked]                          |
| REMOVAL                                    | [ ]                                   |
| CREMATION                                  | [ ]                                   |
| POP                                        | Poplar Springs Cemetery               |
| FRANKLIN, VA                               | FRANKLIN, VA                          |
| NAME OF FUNERAL                            | HARRELL FUNERAL HOME                  |
| ADDRESS                                    | Suffolk, VA                           |
| 47. FUNERAL DIRECTOR SIGNATURE             | Stephen P. Nye Jr.                    |
| 48. REGISTRAR SIGNATURE                    | Dawn C. Haton                         |
| DATE RECORD FILED                          | 22-DEC-1998                           |
|--------------------------------------------|---------------------------------------|

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