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HomeMy WebLinkAbout1921 ST-27 , 080 1~ ~ ~uf~y is ' WFST VlRUIt~t1A STATE DC~AR7AlEt1T OF NEAl.71!-DlYi~lOht OF VllAl STATIS'flCS : ~~u No.-~(;? ~ ~ ~ ~ ~ . ~ti~r,~~~• ii s~~~~~ ti,,. _ 131G ~ CERTiFICAT... C~T' D~/~Tt-i ~ 1~ti82 10 ~ il g I 1. MAAtt UF ~~-a. ~~~t) b. I\1i.~..1~) ~1 .•t1 ~ L It.~7 C (Alunti~l (?l:.r, fl CCCEQSIO / ,y, (l ~yror prudl - - ~ - ~ Ul__~1'11 __l ~.._~_/_~41 ~ Clcrk. , ~O/.SR~ v~.~i~'G /~ir.~.,'-~. .s/ ~ - i ~ ~,3. PIACE Of DEATfi l~ USUJ.??:!SID:S~CC 41:::r..• drr..,,_d Ir.~.t. ..::t~ri:~...n: lirsfdc..ac btjo+. ,'•,;i•~ E~lainly ~ r~~~i~•ri• , ~ h 1~crma- - b. C371'` i_a. S7.V 1 - - t._COU: ~7_1' % • - - - . - t__~ \ ( ~ ~ ~C. ~.f ~~.(/1 ~~t S7AY 1:~ C. ~.1 ~ ~ - ' ~~_:~1 i~i~: Ot' Tl)1ti\ ~j ~ ~ t'~rrualuw~ ~ f ~ 1'O'.1 \ ~~~t- - - ~ --d. \.1 ~!i t1F .:.t ~n hi~+pr.t!. giv. s:.~~t ~:/.treu!---- ---~--d. S77;1.17' :1:!!. :1 - - t , ~~~rit.•r. ~ 11~?.1'!I'AL OR ~ 1\ti! 1'1'liTlO\ r~-0 .p ~ / _ . :11 + ~I a... „i _ i /1 - : <; ~ -e. IS 1'1.:1Cl: Oi~ 1)1::: ~ 11 f:~5S1?i: C'17Y i_l~!7! -~'__j e. 1S lii ~II~F \l`I. !~S)i L7Il' 1.:'.!! (S% ' i. lc R3 `:i~6NCL Otf A FA111T 1'~ ~ ~ro n ~ i•rs ~-~1;;~ U ! ~•t.s ~ U-- S. SI_X 6. Cu~owcr~a l:acc 7. \1wr.c~cn~\FYlR \I+nxtcu~' S. ll:1TEOF f.Ntllt 9. 1cr fln ?.~ur, lo Uwtw 1 1'i~eelF ~INUER N RRl. ~j _ ~ I ~ 1~6ih;:.:o>f _4 itonck• Ua~s ~ Iloart Dfin. ~ _ Y_ RIS~OK~D ~ DI~UPCkA ~ j /f ~ ~ / I ( t f _ • Iva. llsoA~ CI~ClIPAIIpY ((:i~: ?ir..i of x;~k dcr.e ~ IuL. F:~~:. U~ntc~.~~ ! 1),,J~~L" i' Cr.;rr n~ t~ v..~,~•.:r,i t i2. Cnii~.~ o: l~tuT Co~~rni'T du~: rw~t.~ f u~t~.f~i,• ic•% tri • tt:ir. J) i u1t ( u.tnl ~y/ C- 1 GII~' ~`o'J- ~ _ ff~'~~.?'/r~~~ 4~?C~~.~.~ ' ~c:''~1~'1Q sr~ ~i~ _n .~%~~;~i__ I ~.'~:.1J 13. F\"IIIi1i'~ \:1 i.i ~ li. \lUl"1'FR'~ \!AlUL\ \A,'.:L ~ ~SV~,~~i~!G~ !_T__ /Yf"v,~~'/.'"j~~ Wc~~~t• i~~/ . ws Uiu ~SID I.\1R In ~I. S. :~PVID Y!~ac•ccr IG. S~~c~.~i acc.~x~rr \o. f 17. INfORMAN7~ Ad.:ress (Yrs, wo. o~ ~•,kn..r•w)i Ilf )rs. g~:c un or daccs o/ srn•:;r) ~ y ~j~' / . - ~J'~ ' ~/~~_:.~iC~LL ~~y~-..l~~i.l~~d ~~i~~ I6. CAVS~ OF DEATN (E-!rr oniy owt cauu irr linc (or ;~1, tb', ~nd ('a; 1 Y ~ ~crT~,:c~t KETxY~.~ PAR7' I. DE~Tft \~':1S C:1USI ll!?Y: Uaa~T ~ro D~AYH iat~~Enr.~~~i c•:wsr: ;~~/~d. ~~e~~ t~_eA~~ : GL;.?'~'v.e.°~~•%_~ _L~•'~ - / . Cox~lieis.»s, if un?. / ~p ~ u•h~ch xarr riu rv ll(1C 70 (bj/~/'-`.'.'~~~~lC~ ~r~l41'~3~iO~S..~i~ C..~s~~C'.~!~~'! 4~5~~/ ' t~_~ ~is • 4 oL:.s; cause !uy. - it~eir.g tht u~s'Itr- ~ ~ :~i.:~ c~~x :asr. ll:Ui TU C~) - - E i" PART I1. Other signifieant conditions conuibutit~g tu duth bul not criz!r•1 to ~6e tc~minal dixis= eanuition ~i:eq in ; aa I(a)! 1S. R'AS :wTOtsT ~ Q I P.r.:oa~~fn? ~ ~ - - - - - - lIS~~~O~ LL 20a. P.cctnEVr Sutcroc liowc~nc ~ ZOb. DkSC'NIYE 1lot.• 1~ URY O_cUP.tF.D. ~tntft nruuif L en;u ~ 1 f ry in I'r:t d v~ Purt 1! u~ it:rR IS.) ~ ~ W ? ? ? i ~ V 20c. 71\tE A(orth, Bay, )"car, 11our~ - - - ..1 U:= - ~ < i~juKt ~t ~ . ~ - - - - - - ; f o f ttl 2- ~ Q 2C41. C;j[II:Y (X'C'I{tRF"ll 20c. PtwcE or I~JURY (t. tH ur c~~f.[ I~~nu. 20L CIT1 C711\"fY STA7F. . ~V11fL[- AT ~\OT \1'IiiLl' i~~ fcrrn, jac~orr. s~rrd, oj}irt }.1d,v,., rt_.; ~ or ~ ;,;::1~~~IP~ ~ ~ - . TU\1'\ ~ ~t'OAh :1c ~~'O;i~. ~ - - ` - - t'"is tcr- ~~.~iJ~ - I 21. ! mtex ..•d th~ l.eea ~d (•~,n tu~~: /~:.(ss cnei l.st s~r• ~h! dee~~srE aii:e vta.L.~ ~j --.o ~j~ _ - ~ i5 CQII• 14•c•1. r.cuned :t .~_-~~..i m ow t~:t .+.te st..s~d cftn•r, a.d to li.. Lnt o m 3....~•7td J ~ ~rorn 1ha ccrs~s stmei. ~ , :I. 22a SI(,NATURE (U~g,~e or tirlr} 226. ADI:tiJ S5 - ~ 12c. DAT3: SiGtiEll . - ~'`1~~~~`~~ --'~`~4~ ~ ~ _ G.~- 23a. li•tY.1At . l.f ~i, '"-„rs`- ~ ~ ~-r~o~, 2ti.. li\I1 . ~ .~-%a '3d"~--- :t:s: t-a;;~. ~ ~ + _ ~~.l.` ° v~r .ta.. F`•.. ~i'' 4n'SilU:i , j. J' W COYtlt)'~ ~(S-Citf i ~ • c. ':OItiAI ti . ~ a t~; I~ ~ ~VI~ ~ ~ / j ~~q ~ l.nc licic. ~ iJ/- - _ - r`l ~..i~"'~..' ~:43'6 - : ~'t.a._°i''~`."' • ' /~/ri! , ~1Z 2~. DATE RLC~D. Sl' ~ 'r. I:~~ sJ: ~{.'t . - • ' . sa. f,,,~„s.' ;s- -',1 - ~ ~ /A. `r i~ • ~f cr..r~~..~ i • ~~~'S,. ~ , . , ~ ~ ~ ~ F . ~i+_~i ~j!'~:3~-?{ .~n ~/ti' : : ~ .~~i I ~ .'f ~ ' _ / C fi J:.~r.~-~.r~ v.s_.~ T~_3c' ,/Y _.i.fi~,~I ~i' ~ . . ~ ~ z x'S ` STATE OF t•;E:;T V 1 RGI N IA ' _ CACELL COUN',Y COUP.T CLERY.'S OFFICE ~ ~ I, Ke i th L. _~t'.tl~ur, C lerk o~ the s~ i d Court , do liereby cert i f , ~ c~ that the fo;n~~~ipL,!~'as a true ~opy fr~m the record of my off ie~ aforesaicf.: - G. ~ _ .•.t ~ ~r ' i . ^?'CGn ~ _ , ~J ~ `-~C~,~ ~j : Gi ven uncJer! my~ ~hand't=~n~~, seal of the i d Court ~t Hunt i n~ton, 1 ti•Jes t V i~ry i.n i a.;. ;Ch i s. : ~ _ i , W - z c~ _ . : . ' hr,~C . ~ 7 =f C t/~ -r O ' j , r:Z'~~~(l~~• DO~ ~~+~'6~'~ _ ' - ~ • ~ ~ ~ ~ • : • r rn ~ . ,~...Y.~ ~ ~ ~O . . . I~•r~hur, Clerk ~ ~ l.:-.C o~.. - ~ r.~ ; t n Rtw ~_,,~~a~ . C~ E C.~ ~ CC`UiZt)/ COUI't ~~<<~ . r'„ . r ~y: ~ _ ~C:~Uty ~ 224 f~,~~E~.920 ~ ~ p~ .~~~a"~.~ u--- ~ h ` F°-°~ - „ ,~,y,,a~~~ w ` - .s'"~ ~'w ~ . . _