Southampton County Virginia USGenWeb Archives Vitals.....Butler, Ruth, 1912 

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Ruth BUTLER, 10 May 1908 - 6 Nov 1912, 
     death certificate abstract 

______________________________________________________________________________ 

Certificate of Death, No. 12286 [altered]  
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: Southampton Co.; Inc. Town of Burdette 
Primary Registration District No. 873; 
Registered No. [blank] 

Full Name: Ruth Butler 
Residence in City: 4 yrs, 5 mos, 26 days 
______________________________________________________________________________ 

Personal and Statistical Particulars 

Sex: Female 
Color or Race: White 
Single 

Date of Birth: May 10, 1908 
Age: 4 yrs, 5 mos, 26 ds. 

Occupation: None 

Birthplace: Southampton 

Father: 
-Name: E.C. Butler 
-Birthplace: Isle of Wight 

Mother: 
-Maiden Name: Pearl Simmons 
-Birthplace: Southampton 

Informant: E.C. Butler 
            Burdette, Va. 

Burial or Removal: Southampton County, Nov. 7, 1912 
Undertaker: [blank] 

Filed: Nov. 6, 1912 
Registrar: J.R. Council 
______________________________________________________________________________ 

Medical Certificate of Death 
Date of Death: Nov. 6, 1912 

I Hereby Certify, 
That I attended deceased from Nov. 6, 1912 to [blank] 
I last her alive on Nov. 6, 1912 
Death is said to have occurred, on date stated above, at 4 P.M. 

The Cause of Death was as follows: 
Loryngeal Diphtheria 
Duration: 5 ds. 

Contributory (Secondary): 
[blank] 

(Signed) 
T.G. Bradshaw, M.D., Walters, Va. 
[undated] 
______________________________________________________________________________ 

The Library of Virginia, Richmond, VA 
Bureau Of Vital Statistics, Death Certificate 12286 


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/southampton/vitals/deaths/b346r1dc.txt