Southampton County Virginia USGenWeb Archives Vitals.....Roundtree, S.R., 1930 

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S.R. ROUNDTREE, d. 25 Dec 1930, death certificate abstract 

______________________________________________________________________________ 

Certificate of Death, 1146, No. 29847 
Commonwealth of Virginia 
Department of Health 
Bureau of Vital Statistics {BVS} 

Place Of Death: Southampton Co.; 
Magisterial District of Jerusalem 
Registration District No. 873-A; Registered No. 19 

Full Name: S.R. Roundtree 
______________________________________________________________________________ 

Personal and Statistical Particulars 

Sex: male 
Color or Race: white 
Married; Husband of: Myrtle Benson 

Date of Birth: [blank] 

Age: 35 Years 

Occupation: Farming 

Birthplace: N.C. 

Father: 
-Name: Tom Roundtree 
-Birthplace: N.C. 

Mother 
-Maiden Name: Sallie Brown 
-Birthplace: N.C. 

Informant: W.F. Watson 
           Franklin, Va. 

Burial, Cremation, or Removal: near Gatesville, N.C.  Dec. 26, 1930 
Undertaker: Ellis 
          Gatesville, N.C. 

Filed: Dec. 25, 1930 
Registrar: R.S. Maddrey 
______________________________________________________________________________ 

Medical Certificate of Death 
Date of Death: Dec. 25, 1930 

I Hereby Certify, That I attended deceased from [blank] to [blank] 
I last h__ alive on [blank] 
Death is said to have occurred, on date stated above, at [blank] _.M. 

The Principal Cause of Death was as follows: 
   Gun shot by Joe Channel         Date of onset: [blank] 
   self defence 
[Health Dept. code] 197 

Contributory (Secondary): [blank] 

Name of operation: [blank] 
What test confirmed diagnosis? [blank] 
Was there an autopsy? [blank] 

Was disease or injury in any way related to occupation of deceased? [blank] 

(Signed)  [blank] 
______________________________________________________________________________ 


The Library of Virginia, Richmond, VA 
Bureau Of Vital Statistics, Death Certificate 1930 1146-29847 

Contributed for use in USGenWeb Archives by: 
Matt Harris, Zoobug64@aol.com (Dec 2011) [brackets mine] 

file size: 3 Kb 

file at: 
http://files.usgwarchives.net/va/southampton/vitals/deaths/r536s1dc.txt