Death Certificate of Iola Lewis Holland

Iola Lewis Holland died at age 87 on 28 May 1980 at Hillcrest Nursing
Home, Suffolk, Virginia. Her cause of death was cardiac arrest due to
cerebral atherosclerosis and hypertensive ASCVD. She was born on 9 Oct
1892 in Virginia to Nathan T. Lewis and Sarah C. Britt. Iola was
widowed, her spouse was Junius Walter Holland, and she resided in
Suffolk, Virginia.

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| Field                                               | Value                                      |
|-----------------------------------------------------|--------------------------------------------|
| REGISTRATION AREA NUMBER                            | 227                                        |
| CERTIFICATE NUMBER                                  | 213                                        |
| STATE FILE NUMBER                                   | 80-017175                                  |
| 1. FULL NAME OF DECEASED                            | Iola Lewis Holland                         |
| 2. SEX                                              | Female                                     |
| 3. RACE                                             | White                                      |
| 4. DATE OF DEATH                                    | May 28, 1980                               |
| 5. AGE                                              | 87                                         |
| 6. UNDER 1 YEAR                                     | [blank]                                    |
| 7. UNDER 1 DAY                                      | [blank]                                    |
| 8. DATE OF BIRTH                                    | Oct. 9, 1892                               |
| 9. EVER IN U.S. ARMED FORCES?                       | No                                         |
| 10a. NAME OF HOSPITAL OR INSTITUTION                | Hillcrest Nursing Home                     |
| 10b. INSIDE CITY OR TOWN LIMITS?                    | Yes                                        |
| 11. STREET ADDRESS OR RT. NO. OF PLACE OF DEATH     | 200 W. Constance Road                      |
| 12. COUNTY OF DEATH                                 | Suffolk                                    |
| 13. STATE OR FOREIGN COUNTRY OF RESIDENCE           | Virginia                                   |
| 14. CITY OR TOWN OF RESIDENCE                       | Suffolk                                    |
| 15. STREET ADDRESS OR RT. NO. OF RESIDENCE          | Chuckatuck Station                         |
| 16. ZIP CODE                                        | 23432                                      |
| 17. COUNTY OF RESIDENCE                             | Suffolk                                    |
| 18. NAME OF FATHER OF DECEASED                      | Nathan T. Lewis                            |
| 19. BIRTHPLACE (father)                             | USA                                        |
| 20. MAIDEN NAME OF MOTHER OF DECEASED               | Sarah C. Britt                             |
| 21. BIRTHPLACE (mother)                             | Virginia                                   |
| 22. CITIZEN OF WHAT COUNTRY                         | USA                                        |
| 23. USUAL OR LAST OCCUPATION                        | Housewife                                  |
| 24. KIND OF BUSINESS OR INDUSTRY                    | Domestic                                   |
| 25. MARITAL STATUS                                  | Widowed                                    |
| 26. NAME OF SURVIVING SPOUSE                        | Junius Walter Holland                      |
| 27. INFORMANT OR SOURCE OF INFORMATION              | Family                                     |
| 28. CAUSE OF DEATH                                  | Cardiac arrest,                            |
|                                                     | Cerebral atherosclerosis,                  |
|                                                     | Hypertensive ASCVD,                        |
|                                                     | Hypertenion,                               |
|                                                     | ASCVD                                      |
| PART II. OTHER SIGNIFICANT CONDITIONS               | Senility, Chronic organic brain syndrome   |
| 26a. IF FEMALE, PREGNANCY IN PROGRESS?              | No                                         |
| 27. IF DEATH DUE TO EXTERNAL CAUSE                  | [blank]                                    |
| 28. DESCRIBE HOW INJURY RELATES TO DEATH            | [blank]                                    |
| 29. DATE OF INJURY                                  | [blank]                                    |
| 30. HOUR OF INJURY                                  | [blank]                                    |
| 31. INJURY OCCURRED (At Work, Yes/No)               | [blank]                                    |
| 32. PLACE OF INJURY                                 | [blank]                                    |
| 33. PLACE OF INJURY (Name, Street, City, etc)       | [blank]                                    |
| 34. To the best of my knowledge, death occurred at  | [blank]                                    |
| ACTUAL OR PRONOUNCED (circle one)                   | [blank]                                     |
| 35. DATE SIGNED                                     | 6-2-80                                     |
| 36. SIGNATURE & TITLE OF ATTENDING PHYSICIAN        | Phillip R. Thomas, M.D.                    |
| 37. NAME OF ATTENDING PHYSICIAN                     | Phillip R. Thomas, M.D.                    |
| 38. ADDRESS OF ATTENDING PHYSICIAN                  | Suffolk, Va.                               |
| 27. BURIAL REMOVAL CREMATION (circle one)           | Burial                                     |
| 28. PLACE OF BURIAL, REMOVAL, OR CREMATION          | Oakland Christian Church Cemetery, Suffolk |
| 29. LOCATION OF BURIAL OR CREMATION                 | Smithfield, VA                             |
| 30. NAME OF FUNERAL HOME                            | Colonial Funeral Home                      |
| 31. LOCATION OF FUNERAL HOME                        | Smithfield, VA 23430                       |
| 32. SIGNATURE OF FUNERAL DIRECTOR                   | [Signature, illegible]                     |
| 33. LICENSE NUMBER                                  | 554-3                                      |
| 34. SIGNATURE OF REGISTRAR                          | Gloria D. Wright                           |
| 35. DATE FILED                                      | 6/6/80                                     |
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