Isle of Wight County Virginia USGenWeb Archives Vitals.....Uzzell, Willie G., 1926 

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Willie George UZZELL, 5 May 1881 - 6 Oct 1926, death certificate 

[Official Form (printed); handwritten responses <thus>] 
Form No. 12. 
______________________________________________________________________________ 

[header] 
                              Certificate of Death 
1.  Place Of Death          Commonwealth of Virginia 
County Of <Isle of Wight>  Bureau of Vital Statistics       24094 [stamped] 
District of <Hardy>          State Board of Health 
    Or                               ____ 
Inc. Town of [blank] 
    Or                   Registration District No. <460a>  Registered No. <7> 
City of [blank]          (No. [blank]    St.          [blank]    Ward) 

2. Full Name <Willie George Uzzle> 
   (A) Residence.  No.  [blank]     St.     [blank]    Ward     [blank] 
         (Usual place of abode)   (If non-resident give city or town and State) 
______________________________________________________________________________ 
ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ 

[column 1 of 2] 
          Personal and Statistical Particulars 
______________________________________________________________________________ 
 3. Sex <Male>  4. Color or Race <White> 
 5. Single, Married, Widowed, or Divorced (write the word)  <Married> 
 5A. If Married, Widowed, or Divorced, 
     Husband of (or) Wife of <Eva Uzzell**>
 6. Date of Birth <May 5   1881> 19[blank; form too specific]
 7. Age    <45> Years <5> Months <1> Days 
 8. Occupation of Deceased 
  (a) Trade, profession, or particular kind of work <Farming> 
  (b) General nature of industry, 
  business, or establishment in 
  which employed (or employer) [blank] 
  (c) Name of employer [blank] 
______________________________________________________________________________ 
 9. Birthplace 
    (City or Town) <Isle of Wight Va> 
    (State or Country) [blank] 
______________________________________________________________________________ 
Parents 
10. Name of Father <George W. Uzzell> 
11. Birthplace of Father 
    (City or Town) <Isle of Wight Va> 
    (State or Country) [blank] 
12. Maiden Name of Mother <Jennie Pierce> 
13. Birthplace of Mother 
    (City or Town) <Isle of Wight> 
    (State or Country)    <Va>
______________________________________________________________________________ 
14. Informant <George Uzzell> 
    (Address)  <Zuni Va> 
______________________________________________________________________________ 
15. Filed <Oct 7>, 19<'26>   <W.C.[?] Andrews> 
                                      Registrar 
______________________________________________________________________________ 
ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ 

[column 2 of 2] 
          Medical Certificate of Death 
______________________________________________________________________________ 
16. Date of Death <Oct 6th> 19<26> 
17.        I Hereby Certify, That I Attended Deceased From 
    <Oct 6th>, 19<26>  To  <Oct 6th>, 19<26> 
    That I Last Saw H<im> Alive On <Oct 6th>, 19<26> 
    And That Death Occured, On Date Stated Above, At <12 a>M. 
    The Cause of Death* Was As Follows: 
      <Apoplexy> 
                      <129> 
         <->                  Duration  [blank] Yrs. [blank] Mos. [blank] Ds. 
    Contributory <Arterial Hypertension> 
      (Secondary) <with Nephritis> 
         <->                  Duration  [blank] Yrs. [blank] Mos. [blank] Ds. 

18. Where was disease contracted if not at place of death? <-> 
    Did an operation precede death? <no>  Date of [blank] 
    Was there an autopsy? <-> 
    What test confirmed diagnosis? <-> 

         (Signed) <E M Babb>, M.D. 
    <Oct 7>, 19<26>  (Address) <Ivor Va> 
    *State the DISEASE CAUSING DEATH, or in deaths from VIOLENT CAUSES, 
         state (1) MEANS AND NATURE OF INJURY, and (2) whether ACCI- 
         DENTAL, SUICIDAL, or HOMICIDAL. 

______________________________________________________________________________ 

19. Place of Burial, Cremation or Removal      Date of Burial 
    <Antioch>                                 <Oct 8-26> 
20. Undertaker  <C. W. Bailey & Sons> 
    Address <Windsor, Va> 


______________________________________________________________________________ 
[document end] 

The Library of Virginia (LVA), Richmond, VA 
   Bureau Of Vital Statistics, Death Certificate 888-24094 

[**IoW M. Reg. 122 
(Library of VA: Bureau of Vital Statistics Reel 3; 
 Marriage Index, Husbands: 1880-89, R-Z; 1890-99, A-U) 
 UZZELL, Willie m. 17 Dec 1899 STEPHENSON, Evie.

 Uzzell, Mrs Evie Stephenson
 spouse: Willie Uzzell
 dob: 17 Dec 1883 born in VA
 dod: 24 Dec 1940 @ home {BVS Death Index gives d. 23 Dec 1940} 
 funeral: 26 Dec 1940 @ home
 father: Mills Stephenson
 mother: Peggy Bradshaw
 (J T Morris Funeral Home  1939-1942 p 137; abstracted by Ann Marie Piland)] 

Contributed for use in USGenWeb Archives by: 
Matt Harris (Zoobug64@aol.com) [brackets & capitalization mine]. 

file at: 
http://files.usgwarchives.net/va/isleofwight/vitals/deaths/u240w1dc.txt