Death Certificate of Sarah Allen Johnson

Sarah Allen Johnson, 80, died on 9 Aug 1983 in Chesapeake from sepsis
due to toxic epidermal necrolysis. A resident of Chesapeake, she was
married to Samuel Herbert Johnson and was buried at Greenlawn Memorial \
Gardens, Chesapeake, Virginia.

Mrs. Johnson was born in North Carolina on 16 Jan 1903, the daughter of
James Samuel Johnson and Mary A. Corbitt. She lived at 3821 Bruce Road,
Chesapeake, Virginia, and was a homemaker. Her daughter, Jean J.
Holland, was the informant. Autopsy was not performed.

|--------------------------------------|------------------------------------------------------|
| Field                                | Value                                                |
|--------------------------------------|------------------------------------------------------|
| Registration Area Number             | 234                                                  |
| Certificate Number                   | 382                                                  |
| State File Number                    | 83-025319                                            |
| FULL NAME OF DECEASED                | SARAH ALLEN JOHNSON                                  |
| DATE OF DEATH                        | August 9, 1983                                       |
| AGE                                  | 80                                                   |
| DATE OF BIRTH                        | Jan. 16, 1903                                        |
| HOSPITAL                             | Elkhart Nursing Home                                 |
|--                                    | 2614 Elkhart Street                                  |
| COUNTY OF DEATH                      | Chesapeake                                           |
| 234                                  | Virginia                                             |
| RESIDENCE: CITY/TOWN                 | Chesapeake                                           |
| ADDRESS                              | 3821 Bruce Road                                      |
| ZIP CODE                             | 23321                                                |
| 534                                  | -                                                    |
| NAME OF FATHER OF DECEASED           | James Samuel Johnson                                 |
| MAIDEN NAME OF MOTHER OF DECEASED    | Mary A. Corbitt                                      |
| USUAL OCCUPATION                     | Home Maker                                           |
| INFORMANT OR SOURCE OF INFORMATION   | Jean J. Holland – Daughter                           |
| CAUSE OF DEATH                       | Immediate Cause: Sepsis                              |
|--                                    | Due to or consequence of: Topic Epidermal Necrolysis |
| OTHER SIGNIFICANT CONDITIONS         | Chronic Brain Syndrome                               |
| Interval between ONSET and DEATH     | ?                                                    |
| AUTOPSY                              | No                                                   |
| MEDICAL CERTIFICATION                | To the best of my knowledge, death occurred at       |
|--                                    | 1:35 A.M.                                            |
| SIGNATURE OF ATTENDING PHYSICIAN     | Stanley H. Powell, M.D.                              |
|--                                    | 13 Afton Pkwy. Portsmouth, Va. 23702                 |
| DATE SIGNED                          | Aug. 10-83                                           |
| BURIAL, REMOVAL, CREMATION           | XX                                                   |
| NAME OF CEMETERY OR CREMATORY        | Greenlawn Memorial Gardens, Chesapeake, Virginia     |
| FUNERAL DIRECTOR                     | Snellings Churchland Chapel                          |
| ADDRESS                              | Portsmouth, Virginia 23703                           |
| REGISTRAR                            | Margaret E. Miller                                   |
| DATE RECEIVED BY LOCAL RECORD OFFICE | 8-12-83                                              |
| SIGNATURE                            | Marilyn E. Shumaker                                  |
| Boxes checked                        | BURIAL (checked)                                     |
|--                                    | AUTOPSY: No (checked)                                |
|--------------------------------------|------------------------------------------------------|

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