Death Certificate of Janette H Mayes

Janette H. Mayes, 71, died on 26 Jun 1967 in Richmond from ruptured
heart due to myocardial infarction. A resident of Story Creek, she was
Married to Myron H. Mayes and was buried in July 1967 at Concord Church
Cemetery, Sussex Co., Va.

Mrs. Mayes was born on 2 Sep 1895 in Greensville Co., Virginia. She was
a housewife, daughter of William H. Mitchell and Eugenda G. Mitchell,
and a citizen of the U.S.A. Her death occurred at Johnston Willis
Hospital, Richmond, Virginia.

|-----------------------------------------------------------------|
| Field                                 | Value                   |
|---------------------------------------|-------------------------|
| REGISTRATION AREA NUMBER              | 222                     |
| CERTIFICATE NUMBER                    | 2051                    |
| STATE FILE NUMBER                     | 67 016429               |
| 1. FULL NAME OF DECEASED              | Janette H. Mayes        |
| 2. SEX                                | female                  |
| 3. DATE OF DEATH                      | June 26 1967            |
| 4. AGE OF DECEASED                    | 71                      |
| 5. USUAL COLOR OR RACE                | White                   |
| 6. MARITAL STATUS                     | Married                 |
| 7. NAME OF HOSPITAL OR INSTITUTION    | Johnston Willis         |
| 8. COUNTY                             | Richmond                |
| 9. CITY OR TOWN OF DEATH              | Richmond                |
| 9. ADDRESS                            | 2908 Kensington Ave.    |
| 10. STATE OR FOREIGN COUNTRY          | Va.                     |
| 11. COUNTY                            | Sussex                  |
| 12. CITY OR TOWN                      | Story Creek             |
| 12. ADDRESS                           | R.F.D. #2               |
| 13. NAME OF FATHER OF DECEASED        | William H. Mitchell     |
| 14. NAME OF MOTHER OF DECEASED        | Eugenda G. Mitchell     |
| 15. DECEASED CITIZEN OF WHAT COUNTRY  | U.S.A.                  |
| 16. USUAL OR LAST OCCUPATION          | Housewife               |
| 17. MARRIED                           | Widow                   |
| 18. NAME OF SPOUSE                    | Myron H. Mayes          |
| 19. BIRTHPLACE                        | Greensville Co.         |
| 20. DATE OF BIRTH OF DECEASED         | Sept. 26, 1895          |
| 21. INFORMANT                         | Mrs. Dorothy Johnson    |
| 21. ADDRESS                           | 420.1                   |
| 26a. IMMEDIATE CAUSE                  | Ruptured heart          |
| 26a. DUE TO                           | Myocardial infarction   |
| 26a. Due to                           | (blank)                 |
| 26a. OTHER SIGNIFICANT CONDITIONS     | Graves disease          |
| 26b. AUTOPSY                          | No                      |
| 26b. Interval Between Onset and Death |                         |
| 27. PREGNANCY IN PAST 3 MONTHS?       | No                      |
| 28.                                   | [blank]                 |
| 29. TIME OF DEATH CERTIFICATION       | 6-26-67                 |
| 30. MEDICAL CERTIFICATION SIGNATURE   | Glynn A. Turner, M.D.   |
| REMOVAL OR CREMATION PLACED AT        | Concord Church Cemetery |
| REMOVAL OR CREMATION COUNTY           | Sussex, Co., Va.        |
| NAME OF FUNERAL HOME                  | Owen Funeral Home       |
| ADDRESS                               | Jarratt, Va.            |
| DATE SIGNED                           | July 1967               |
| REGISTRAR SIGNATURE                   | N. L. [illegible]       |
|-----------------------------------------------------------------|

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