Death Certificate of Lewis, Valeria Boyette

Valeria Boyette Lewis, age 86, died of cardiopulmonary arrest due to
stroke on 4 Apr 1992 at East Pavilion, Franklin, Virginia. Born 15 Nov
1905 in North Carolina to Henry Pate and Frances Pridgon, she was
widowed, spouse Nathan Thomas Lewis. She resided at East Pavilion,
Franklin, Virginia.

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| Field                                                        | Value                              |
|--------------------------------------------------------------|------------------------------------|
| REGISTRATION AREA NUMBER                                     | 233                                |
| CERTIFICATE NUMBER                                           | 048                                |
| STATE FILE NUMBER                                            | 92-012870                          |
| 1. FULL NAME OF DECEDENT                                     | Valeria Boyette Lewis              |
| 2. DATE OF DEATH (Mo, day, yr)                               | April 4, 1992                      |
| 3. AGE                                                       | 86                                 |
| 4. DATE OF BIRTH (Mo, day, yr)                               | Nov. 15, 1905                      |
| 5. SEX                                                       | Female                             |
| 6. WAS DECEDENT EVER IN U.S. ARMED FORCES?                   | No                                 |
| 7. NAME OF HOSPITAL OR INSTITUTION OF DEATH                  | East Pavilion                      |
| 8. CITY OR TOWN OF DEATH                                     | Franklin                           |
| 9. COUNTY OF DEATH                                           | Franklin                           |
| 10. ADDRESS                                                  | [Blank]                            |
| 11. STATE OR FOREIGN COUNTRY OF DECEDENT'S RESIDENCE         | Virginia                           |
| 12. COUNTY OF RESIDENCE                                      | Franklin                           |
| 13. CITY OR TOWN OF RESIDENCE                                | Franklin                           |
| 14. ADDRESS                                                  | 100 Fairview Dr.                   |
| 15. ZIP CODE                                                 | 23851                              |
| 16. NAME OF DECEDENT'S FATHER                                | Henry Pate                         |
| 17. NAME OF DECEDENT'S MOTHER                                | Frances Pridgon                    |
| 18. MAIDEN NAME OF DECEDENT'S MOTHER                         | Frances Pridgon                    |
| 19. EDUCATION (Specify only highest grade completed)         | 10                                 |
| 20. RACE OF DECEDENT                                         | White                              |
| 21. CITIZEN OF WHAT COUNTRY                                  | USA                                |
| 22. BIRTHPLACE (state or country)                            | North Carolina                     |
| 23. USUAL OCCUPATION                                         | Health Care Nurse                  |
| 24. KIND OF BUSINESS OR INDUSTRY                             | Self Employed                      |
| 25. MARITAL STATUS                                           | Widowed                            |
| 26. SPOUSE:                                                  | Nathan Thomas Lewis                |
| 27. INFORMANT OR SOURCE OF INFORMATION                       | Norma B. Alphin                    |
| PART I. IMMEDIATE CAUSE (Final disease or condition)         | Cardiopulmonary Arrest             |
| PART I. DUE TO (OR AS A CONSEQUENCE OF)                      | Stroke                             |
| PART II. OTHER SIGNIFICANT CONDITIONS                        | [Blank]                            |
| 28a. AUTOPSY?                                                | No                                 |
| 28b. IF FEMALE, WAS THERE A PREGNANCY IN THE LAST 12 MONTHS? | No                                 |
| 28c. IF EXTERNAL CAUSE, IF WAS IT                            | [Blank]                            |
| 28d. DESCRIBE HOW INJURY RELATING TO DEATH OCCURRED          | [Blank]                            |
| 28e. PLACE OF INJURY (Home, Farm, Street, etc.)              | [Blank]                            |
| 28f. INJURY AT WORK?                                         | [Blank]                            |
| TIME OF DEATH                                                | 12:45 P.M.                         |
| ACTUAL OR PRESUMED DATE OF DEATH                             | 4-4-92                             |
| SIGNATURE OF ATTENDING PHYSICIAN                             | Aurelius M. Brantley, M.D.         |
| ADDRESS OF ATTENDING PHYSICIAN                               | Suite 162 Southampton Med. Bldg.   |
| 29. NAME OF FUNERAL HOME                                     | Hill Funeral Home                  |
| 30. ADDRESS                                                  | 447 W. Washington St., Suffolk     |
| 31. PLACE OF BURIAL, CREMATION, OR REMOVAL                   | Holly Lawn Cemetery                |
| 32. LOCATION (City or County)                                | Suffolk, Va.                       |
| 33. DATE OF BURIAL, CREMATION, OR REMOVAL                    | 4-6-92                             |
| REGISTRAR SIGNATURE                                          | Nanette B Whitehurst               |
| DATE FILED                                                   | 4-6-92                             |
| RESERVED FOR REGISTRAR'S USE                                 | [Blank]                            |
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