Death Certificate of Haywood, Maggie Lee



Maggie Lee Haywood, age 87, born 13 Sep 1869 in Southampton County,
Virginia to Meredith W. Holland and Lucy F. Britton, widowed spouse of
James Leslie Haywood, resided at 1537 Monterey Avenue, Norfolk,
Virginia. She died on 24 Jan 1957 at Godwin Nursing Home, Norfolk,
Virginia. Cause of death was uremia due to nephrosclerosis and
arteriosclerosis.

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| Field                                 | Value                                         |
|---------------------------------------|-----------------------------------------------|
| Registration No.                      | 167                                           |
| Certificate No.                       | 549                                           |
| County                                | Norfolk                                       |
| City or Town                          | Norfolk                                       |
| Hospital or Institution               | Godwin Nursing Home, Stockley Gardens         |
| Is place of death inside city limits? | Yes                                           |
| Residence                             | 1537 Monterey Avenue, Norfolk, Virginia       |
| Is residence inside city limits?      | Yes                                           |
| Full Name of Deceased                 | Maggie Lee Haywood                            |
| Sex                                   | Female                                        |
| Color or Race                         | White                                         |
| Marital Status                        | Widowed                                       |
| Name of Husband or Wife of Deceased   | James Leslie Haywood                          |
| Date of Birth                         | 13 Sep 1869                                   |
| Age                                   | 87 years, 4 months, 11 days                   |
| Usual Occupation                      | Own Home                                      |
| Birthplace                            | Southampton County, Virginia, USA             |
| Father's Name                         | Meredith W. Holland                           |
| Mother's Maiden Name                  | Lucy F. Britton                               |
| Informant                             | Mr. M. T. Wills, Norfolk, Va.                 |
| Date of Death                         | 24 Jan 1957                                   |
| Immediate Cause of Death              | Uremia                                        |
| Due to                                | Nephrosclerosis                               |
| Other significant conditions          | Arteriosclerosis                              |
| Interval between onset and death      | 4 years                                       |
| Autopsy performed                     | No                                            |
| Place of Injury                       | None                                          |
| Injury at work                        | No                                            |
| Attended deceased from                | 19 Jan 1956 to 24 Jan 1957                    |
| Date death occurred                   | 24 Jan 1957                                   |
| Time of death                         | 9:10 A.M.                                     |
| Certifying Physician                  | Sam Ricks, M.D.                               |
| Date signed                           | 26 Jan 1957                                   |
| Address (Physician)                   | Norfolk, Virginia                             |
| Burial, Cremation, or Removal         | Removal                                       |
| Date (Burial, Cremation, or Removal)  | 26 Jan 1957                                   |
| Name of Cemetery or Crematory         | Transportation of the remains to Richmond,Va. |
| Funeral Director                      | Hollomon Brown Funeral Home, Inc.             |
| Address (Funeral Director)            | Norfolk, Virginia                             |
| Date received by local registrar      | 28 Jan 1957                                   |
| Registrar’s signature                 | J. C. Cerft                                   |
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