Southampton County Virginia USGenWeb Archives Vitals.....Cheyney, Ellen Moore, 1920 

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Ellen (MOORE; Mrs. Jesse S.) CHEYNEY, 
     27 Nov 1835 - 13 Oct 1920, 
     death certificate abstract 

______________________________________________________________________________ 

Certificate of Death, No. 25247 
Commonwealth of Virginia 
State Board of Health 
Bureau of Vital Statistics {BVS} 
Form No. 12. 

Place Of Death: County of Southampton; 
                District of Berlin & Ivor; 
                Inc. Town of Ivor, R.D. 
Registration District No. 873-C 
Registered No. 4 

Full Name: Ellen M. Cheyney 
______________________________________________________________________________ 

Personal and Statistical Particulars 

Sex: Female 
Color or Race: White 
Marital Status: Widowed 
Spouse of: Jesse M. Cheyney 

Date of Birth: Nov_ 27_ 1835 
Age: 84 yrs. 10 mos. 16 ds. 

Occupation: none 

Birthplace: Philadelphia_ 
               Pa _ 

Father: 
-Name: Walker Moore 
-Birthplace: Penna _ 

Mother: 
-Maiden Name: Mary Ann Moore 
-Birthplace:        Pa _ 

Informant: Mrs. H.D. Raiford 
                 Ivor  Va. 

Burial or Removal: Philadelphia Pa., 10/16, 1920 
Undertaker: W.J.M. Holland & Son 
            Franklin_ Va. 

Filed: 11/19, 1920 
Registrar: C.T. Stephenson 
______________________________________________________________________________ 

Medical Certificate of Death 
Date of Death: Oct. 13 _ 1920 

I Hereby Certify, 
That I attended deceased from 
   Died instantly before 
   I arrived at home. 
Death is said to have occurred, on date stated above, at 5:30 a.m. 

The Cause of Death was as follows: 
   Apoplexy 
Duration: [check mark] 

Contributory (Secondary): age 
Duration: [check mark] 

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

Did an operation precede death? no 

Was there an autopsy? no 

What test confirmed diagnosis? History of Symptoms 


(Signed) R.L. Raiford, M.D. 
[not dated]   Sedley  Va 
______________________________________________________________________________ 

The Library of Virginia, Richmond, VA 
Bureau Of Vital Statistics, Death Certificate 1920-25247 


*Additional information: 

The informant is her daughter Edith S. (CHEYNEY; Mrs. Hunter D.) RAIFORD. 
   Also a Philadelphia native, she is buried in Rosemont Cemetery, Sedley. 
   Southampton County Historical Society {SCHS} Cemetery Project, 
   Rosemont list (S-56): 
   http://files.usgwarchives.net/va/southampton/cemeteries/rosemont.txt 

Dr. Rufus L. RAIFORD was Edith's brother-in-law. 


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

file size: 4 Kb 

file at: 
http://files.usgwarchives.net/va/southampton/vitals/deaths/c500e1dc.txt