Isle of Wight-Surry County Virginia USGenWeb Archives Vitals.....Pegram, Minerva J. Wilson, 1921 

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Minerva Jones (WILSON; Mrs. B.) PEGRAM, 
     6 May 1838 - 19 Mar 1921, 
     death certificate abstract 

______________________________________________________________________________ 

Certificate of Death, No. 5913 
Commonwealth of Virginia 
Bureau of Vital Statistics {BVS} 
State Board of Health 
Form No. 12. 

Place Of Death: County of Isle of Wight; 
                Magisterial District of Newport 
                Inc. Town of Town of Smithfield 
Registration District No. 461-B 
Registered No. 16 

Full Name: Minerva Jones Pegram 
              Smithfield, Va. 
______________________________________________________________________________ 

Personal and Statistical Particulars 

Sex: Female 
Color or Race: White 
Marital Status: Widow 
Spouse of: Mr. Blair [?] Pegram 
Date of Birth: 6th of May, 1838 
Age: 82 years, 10 months, 22 days 

Occupation: formerly 
               Housewife 

Birthplace: Surry Co, Virginia 

Father: 
-Name: John Wilson 
-Birthplace: Surry Co, Va 

Mother: 
-Maiden Name: Minerva Jones 
-Birthplace: Surry Co, Va 

Informant: May P. Jones 
             Smithfield, Va. 

                               Bacon's Castle 
Burial or Removal: Old Brick Church*, March 20, 1921 
Undertaker: G.W. Cofer 
            Smithfield, Va. 

Filed: Mar. 21, 1921 
Registrar: J. Walter Stott 
______________________________________________________________________________ 

Medical Certificate of Death 
Date of Death: Mch. 19, 1921 

I Hereby Certify, 
That I attended deceased from 
Jan. 1, 1917 to Mch. 19, 1921 
I last her alive on Mch. 19, 1921 
and that death occurred, on date stated above, at 7 A.M. 

The Cause of Death was as follows: 
   General Aenemia[?] 
Duration: 4 yrs. 

Contributory (Secondary): Age 

Where was disease contracted if not at place of death? [blank] 

Did an operation precede death? no 

Was there an autopsy? no 

What test confirmed diagnosis? [blank] 

(Signed)  L.C. Brock, M.D. 
3-20, 1921   Smithfield, Va. 
______________________________________________________________________________ 



The Library of Virginia, Richmond, VA 
Bureau Of Vital Statistics, Death Certificate 1921-5913 


*Cemetery not posted (Oct 2013) by the Surry County Historical Society. 
   "The Old Brick Church" is also a nickname for St. Luke's, 
   in Isle of Wight Co. 


Contributed for use in USGenWeb Archives by: 
Matt Harris, zoobug64@aol.com (Nov 2013) [brackets mine] 

file size: 3 Kb 

file at: 
http://files.usgwarchives.net/va/isleofwight/vitals/deaths/p265m1dc.txt