Death Certificate of William Bruce Rose

William Bruce Rose, 1 year 9 months, died on 17 Jun 1913 in Sussex
County, Va. due to colitis, Acute and Meningeal infection. A resident
of Waverly, he was buried on 19 Jun 1913 at Franklin, Va.

Mr. Rose was the son of W. E. Rose and Ada Luealla Bruce, born in
Waverly, Va.  His parents were born in near Franklin, Va., No occupation
was listed. Death occurred at 4:35 PM.

|-----------------------------------------------------------------------------------|
| Field                                             | Value                         |
|---------------------------------------------------|-------------------------------|
| County of                                         | Suxxex                        |
| District of                                       | Waverly, Va                   |
| Inc. Town of                                      | Waverly, Va                   |
| or City of                                        | -                             |
| Registration District No.                         | 914                           |
| Primary Registration District No.                 | 914-B                         |
| Registered No.                                    | 32                            |
| 2. FULL NAME                                      | William Bruce Rose            |
| 3. SEX                                            | Boy                           |
| 4. COLOR OR RACE                                  | White                         |
| 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED          | Single                        |
| 6. DATE OF BIRTH                                  | Sep 10th, 1911                |
| 7. AGE                                            | 1 yrs. 9 mos.                 |
| 8. OCCUPATION                                     | -                             |
| 9. BIRTHPLACE                                     | Waverly, Va.                  |
| 10. NAME OF FATHER                                | W. E. Rose                    |
| 11. BIRTHPLACE OF FATHER                          | near Franklin                 |
| 12. MAIDEN NAME OF MOTHER                         | Ada Luealla Bruce             |
| 13. BIRTHPLACE OF MOTHER Franklin Co. Va.         | near Franklin                 |
| 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE | W. E. Rose                    |
| 14.                                               | Waverly, Va.                  |
| 15. Filed                                         | June 18, 1913 C C Crafford    |
| 16. DATE OF DEATH                                 | June 17, 1913                 |
| 17. I ATTENDED DECEASED FROM                      | June 2, 1913 to June 17, 1913 |
| 17. That I last saw him alive on                  | June 17, 1913                 |
| 17. Death occurred, on the date stated above, at  | 4:35 PM                       |
| 17. THE CAUSE OF DEATH                            | Ileo Colitis, Acute           |
| 17.                                               | 17 days                       |
| Contributory                                      | Meningeal infection           |
| Contributory(Duration)                            | -                             |
| Signed                                            | [illegible] M.D.              |
| Date                                              | June 18, 1913                 |
| Address                                           | Waverly Va.                   |
| STATE THE DISEASE CAUSING DEATH...                | -                             |
| 18. Length of residence:                          | -                             |
| 18. – in city or town where death occurred        | -                             |
| 18. – in State                                    | -                             |
| 18. – yrs. mos.                                   | -                             |
| PLACE OF BURIAL OR REMOVAL                        | Franklin, Va.                 |
| DATE OF BURIAL                                    | June 19, 1913                 |
| UNDERTAKER                                        | J A Grammer                   |
| ADDRESS                                           | Waverly Va.                   |
|-----------------------------------------------------------------------------------|

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