Southampton County Virginia USGenWeb Archives Vitals.....Hagin, Jacqueline F., 1919 

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Jacqueline F. HAGIN, 
   18 Apr 1919 - 19 Jul 1919, 
   death certificate abstract 

______________________________________________________________________________ 

Form No. 12. 
Certificate of Death, Vol. 477, File No. 20087 
Commonwealth of Virginia 
State Board of Health 
Bureau of Vital Statistics {BVS} 

Place Of Death: 
   County of Southampton 
   Magisterial District of Newsoms 
Registration District No. 872a 
Registered No. 24 

Full Name: Jacqueline Hagin 
______________________________________________________________________________ 

Personal and Statistical Particulars 

Sex: female 
Color or Race: white 
Marital Status: single 

Date of Birth: April 20th, 1919 ["May 14" struck*] 
Age: 2 mos, 20 days 

Occupation: none 

Birthplace: Waynesboro, Ga. 

Father: 
-Name: E.M. Hagin* 
-Birthplace: Douglasville, Ga  U.S.A. 

Mother: 
-Maiden Name: Miss Linda Anderton 
-Birthplace: Saluda, Va  U.S.A. 

Informant: W.S. McGraw 
  Address:    Newsoms, Va. 

Filed: July 20, 1919 
Local Registrar: Solon L. Bryant 
______________________________________________________________________________ 

Medical Certificate of Death ["Birth" struck- printers' error] 

Date of Death: July 19, 1919 

I Hereby Certify, 
That I attended deceased from July 13, 1919, to July 19, 1919, 
    that I last saw her alive on July 19, 1919, 
    and that death occurred, on the date stated above, 
    at _____ _.M. 


The Cause of Death was as follows: 
   Diarrhea 
Duration: [blank] 

Contributory (Secondary): Bottle fed 


     (Signed)  B.A. Pope, M.D. 
July 20, 1919        Newsoms, Va. 

Burial or Removal: Newsoms*, July 20, 1919 
Undertaker: G.P. Vick 
            Newsoms, Va. 
______________________________________________________________________________ 


The Library of Virginia 
Bureau Of Vital Statistics, Death Certificate 1919-477-20087 


*Additional information: 

Buried in Hollywood Cemetery, Newsoms.  Middle initial & birthdate from 
   cemetery list; notes there give her father's name as Edward Newsum HAGIN. 
   Southampton County Historical Society {SCHS} Cemetery Project, 
   Hollywood list (N-39): 
   http://files.usgwarchives.net/va/southampton/cemeteries/hollywd.txt 


Contributed for use in USGenWeb Archives by: 
Matt Harris, zoobug64@aol.com (Jan 2014) [brackets mine] 

file size: 3 Kb 

file at: 
http://files.usgwarchives.net/va/southampton/vitals/deaths/h250j1dc.txt