Death Certificate of Odom, Lillie Wheeler

Narrative summary of the form data:

Lillie Wheeler Odom, age 63, was born 1 Jan 1907 in North Carolina to
Rufus Daniel Wheeler and Mary Coggins. She resided at 222 Monroe Street,
Roanoke Rapids, North Carolina. She was married, spouse Eugene Odom. She
died 25 Dec 1970 at Roanoke Rapids Hospital, Halifax County, North
Carolina, from acute vascular occlusion due to cerebral thrombosis.

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| Field                                            | Value                                              |
|--------------------------------------------------|----------------------------------------------------|
| 1. NAME OF DECEASED                              | LILLIE WHEELER ODOM                                |
| 2. SEX                                           | female                                             |
| 3. COLOR OR RACE                                 | white                                              |
| 4. STATE OF BIRTH                                | North Carolina                                     |
| 5. DATE OF BIRTH                                 | January 1, 1907                                    |
| 6. AGE                                           | 63                                                 |
| 7. DATE OF DEATH                                 | December 25, 1970                                  |
| 8. COUNTY OF DEATH                               | Halifax                                            |
| 9. CITY OR TOWN                                  | Roanoke Rapids                                     |
| 10. PLACE OF DEATH: HOSPITAL OR INSTITUTION      | Roanoke Rapids Hospital                            |
| 11. INSIDE CITY LIMITS (Place of Death)          | Yes                                                |
| 12. USUAL RESIDENCE: STATE                       | North Carolina                                     |
| 13. USUAL RESIDENCE: COUNTY                      | Halifax                                            |
| 14. USUAL RESIDENCE: CITY OR TOWN                | Roanoke Rapids                                     |
| 15. USUAL RESIDENCE: STREET ADDRESS              | 222 Monroe Street                                  |
| 16. INSIDE CITY LIMITS (Usual Residence)         | Yes                                                |
| 17. MARITAL STATUS                               | Married                                            |
| 18. SURVIVING SPOUSE (if wife, give maiden name) | Eugene Odom                                        |
| 19. SOCIAL SECURITY NUMBER                       | 238-10-4790                                        |
| 20. USUAL OCCUPATION                             | Spinner                                            |
| 21. KIND OF BUSINESS OR INDUSTRY                 | Textiles                                           |
| 22. CITIZEN OF WHAT COUNTRY                      | U.S.A.                                             |
| 23. FATHER'S NAME                                | Rufus Daniel Wheeler                               |
| 24. MOTHER'S MAIDEN NAME                         | Mary Coggins                                       |
| 25. INFORMANT'S NAME AND ADDRESS                 | Eugene Odom, 222 Monroe Street, RoanokeRapids,N.C. |
| 26. IMMEDIATE CAUSE OF DEATH                     | Cerebral Vascular Accident                         |
| 27. DUE TO, OR AS A CONSEQUENCE OF               | (blank)                                            |
| 28. OTHER SIGNIFICANT CONDITIONS                 | (blank)                                            |
| 29. AUTOPSY                                      | No                                                 |
| 30. WAS THERE SURGICAL OPERATION?                | No                                                 |
| 31. WAS THIS DEATH CAUSED BY INJURY?             | No                                                 |
| 32. CERTIFICATION: I ATTENDED THE DECEASED FROM  | Dec. 23, 1970 to Dec. 25, 1970                     |
| 33. LAST SEEN ALIVE AT                           | Dec. 25, 1970                                      |
| 34. DEATH OCCURRED AT                            | 2:30 AM                                            |
| 35. SIGNATURE OF CERTIFIER                       | [Signature present, name not typed]                |
| 36. DATE SIGNED                                  | 12-25-70                                           |
| 37. ADDRESS (Certifier)                          | Roanoke Rapids, N.C.                               |
| 38. BURIAL, CREMATION, OR REMOVAL                | Burial                                             |
| 39. DATE OF BURIAL, CREMATION, OR REMOVAL        | Dec. 27, 1970                                      |
| 40. NAME OF CEMETERY OR CREMATORY                | Family Cemetery                                    |
| 41. LOCATION (Cemetery)                          | Conway                                             |
| 42. FUNERAL HOME                                 | Wrenn-O'Neal, Roanoke Rapids, N.C.                 |
| 43. SIGNATURE OF FUNERAL DIRECTOR                | [Signature present, name not typed]                |
| 44. LICENSE NO. (Funeral Director)               | 1255                                               |
| 45. LICENSE NO. (Embalmer)                       | 843                                                |
| 46. DATE RECEIVED BY LOCAL REG.                  | 12-30-70                                           |
| 47. SIGNATURE OF REGISTRAR                       | [Signature present, name not typed]                |
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