Southampton-Isle of Wight County Virginia USGenWeb Archives Vitals.....Mumford, Catherine, 1920 

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Catherine (Cathron) MUMFORD (MUNFORD), 
     circa Aug 1919 - 13 Jan 1920, death certificate 

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

[header] 
                              Certificate of Death 
1.  Place Of Death          Commonwealth of Virginia 
County Of  <Southampton>   Bureau of Vital Statistics        2073 [stamped] 
Magisterial                   State Board of Health 
District of <Franklin  Va>            ____ 
    Or                     
Inc. Town of <Hardy Dist> 
    Or                   Registration District No. <874>  Registered No. <1> 
City of [blank]          (No. [blank]    St.          [blank]    Ward) 

2. Full Name <Cathron Mumford> 
   (A) Residence.  No.  [blank]     St.     [blank]    Ward     [blank] 
         (Usual place of abode)   (If non-resident give city or town and State) 
______________________________________________________________________________ 
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[column 1 of 2] 
          Personal and Statistical Particulars 
______________________________________________________________________________ 
 3. Sex <Female>  4. Color or Race <Whiet> 
 5. Single, Married, Widowed, or Divorced (write the word)  <Single> 
 5A. If Married, Widowed, or Divorced, 
     Husband of (or) Wife of [blank] 
 6. Date of Birth [blank] 19<19>
 7. Age    [blank] Years <5> Months <-> Days 
 8. Occupation of Deceased 
  (a) Trade, profession, or particular kind of work <-> 
  (b) General nature of industry, 
  business, or establishment in 
  which employed (or employer) <-> 
  (c) Name of employer [blank] 
______________________________________________________________________________ 
 9. Birthplace 
    (City or Town)       <Va> 
    (State or Country) [blank] 
______________________________________________________________________________ 
Parents 
10. Name of Father <W.T. Munford> 
11. Birthplace of Father 
    (City or Town)       <Va> 
    (State or Country) [blank] 
12. Maiden Name of Mother <Crissie Carr> 
13. Birthplace of Mother 
    (City or Town)        <Va> 
    (State or Country) [blank] 
______________________________________________________________________________ 
14. Informant <W.T. Mumford> 
    (Address)     <Franklin Va> 
______________________________________________________________________________ 
15. Filed <Feby 9>, 19<20>   <C.C. Vaughan> 
                                      Registrar 
______________________________________________________________________________ 
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[column 2 of 2] 
          Medical Certificate of Death 
______________________________________________________________________________ 
16. Date of Death <Jany 13> 19<20> 
17.        I Hereby Certify, That I Attended Deceased From 
    [blank], 19[blank]  To  [blank], 19[blank] 
    That I Last Saw H[blank] Alive On [blank], 19[blank] 
    And That Death Occured, On Date Stated Above, At <11_30 am>M. 
    The Cause of Death* Was As Follows: 
           <No Dr> 
      <had a fall:> 
                              Duration  [blank] Yrs. [blank] Mos. [blank] Ds. 
    Contributory [blank] 
      (Secondary)             Duration  [blank] Yrs. [blank] Mos. [blank] Ds. 

18. Where was disease contracted if not at place of death? [blank] 
    Did an operation precede death? [blank]  Date of [blank] 
    Was there an autopsy? [blank] 
    What test confirmed diagnosis? [blank] 

         (Signed) [blank] M.D. 
    [blank], 19[blank]  (Address) [blank] 
    *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 
    <Southampton Co near>                      <1/14>  19<20> 
             <Franklin Va> 
20. Undertaker  <W.J.M. Holland> 
    Address <Franklin Va> 
______________________________________________________________________________ 
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[document end] 

The Library of Virginia (LVA), Richmond, VA 
   Bureau Of Vital Statistics, Death Certificate 504-2073 

[The 1920 Census index (Soundex) lists an infant by this name.  The actual 
 returns need to be examined to determine whether she is the child whose 
 death is recorded above. (Southampton  212-1-79) 
 Munford, William T., 41; Crissie, 32, wife; Elizabeth, 13, dt; 
 Ruth Annie, 12, dt; River[?] Lee, 9, son; Mary Jane, 7, dt; 
 Ashley E., 5, son; Charlie E., 3 & 2/12, son; Katherine, 4/12, dt. 

 William killed his estranged wife Crissie, and then himself, 
 6 May 1928, in Roanoke Rapids, NC.  News item posted at: 
 http://files.usgwarchives.net/va/southampton/news/05111928s.txt] 

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

file at: 
http://files.usgwarchives.net/va/southampton/vitals/deaths/m516c1dc.txt