Greensville County Virginia USGenWeb Archives Vitals.....Pair, Benjamin H., 1912 

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Benjamin H. PAIR, 26 Dec 1840 - 30 Dec 1912, 
   death certificate abstract 

______________________________________________________________________________ 

Certificate of Death, No. Vol. 27, 13311 ["12852" struck]  
Commonwealth of Virginia 
State Board of Health 
Bureau of Vital Statistics {BVS} 
H.D.V.S. Form No. 12, 200M.--6-15-12. 

Place Of Death: Greensville Co.; Hicksford District 
Registration District No. 401 
Registered No. 27 

Full Name: Benjiman [sic; Benjamin] H. Pair 
______________________________________________________________________________ 

Personal and Statistical Particulars 

Sex: Male 
Color or Race: White 
Marital Status: Widowed 

Date of Birth: December 26, 1840 
Age: 72 yrs, 4 ds. 

Occupation: Farming 

Birthplace: Virginia 

Father: 
-Name: Howell [Pair]  
-Birthplace: Virginia 

Mother: 
-Name: Matilda Mitchell 
-Birthplace: Virginia 

Informant: C.T. Williams 
            Ante, Va. 

Filed: Jan. 10th, 1912 [sic; 1913] 
Registrar: W.P. Stublen[?] 
______________________________________________________________________________ 

Medical Certificate of Death 

Date of Death: December 30th, 1912 

I Hereby Certify, 
That I attended deceased from Dec. 20th, 1912 to Dec. 22nd, 1912, 
that I last saw him alive on Dec. 22nd, 1912, 
and that death occurred, on the date stated above, at _____.M. 

The Cause of Death was as follows: 
A Stroke of Paralysis 
 This man died before I 
 could See him on date of death 
Duration: [blank] 
    
Contributory (Secondary): [blank] 
Duration: [blank] 

(Signed) 
R.H. Sims, M.D., Powellton, Va. 
Jan. 6th, 1913 


Burial or Removal: [place- blank] Dec.  1912 
Undertaker: H.W. Hall & Bro., Emporia, Va. 
______________________________________________________________________________ 

The Library of Virginia 
Bureau Of Vital Statistics, Death Certificate 27-13311 

Contributed for use in USGenWeb Archives by: 
Matt Harris, zoobug64@aol.com (Oct 2012) [brackets mine] 

file size: 3 Kb 

file at: 
http://files.usgwarchives.net/va/greensville/vitals/deaths/p600b1dc.txt