Southampton County Virginia USGenWeb Archives Vitals.....Story, Margaret E. Williams, 1923 

************************************************
Copyright.  All rights reserved.
http://www.usgwarchives.net/copyright.htm
http://www.usgwarchives.net/va/vafiles.htm
************************************************

Margaret Ellen (WILLIAMS; Mrs. Elliott L.) STORY, 
     7 Feb 1845 - 14 Sep 1923, 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        23538 [stamped] 
Magisterial                   State Board of Health 
District of <Franklin>                ____ 
    Or                     
Inc. Town of <Franklin, Va> 
    Or                   Registration District No. <2874>  Registered No. <42> 
City of [blank]          (No. <309>, <W. First Ave.> St.;      [blank]  Ward) 

2. Full Name <Margaret Ellen Story> 
   (A) Residence. <Frankin; Va>   St.     [blank]    Ward     [blank] 
         (Usual place of abode)   (If non-resident give city or town and State) 
Length of residence in city or town 
where death occurred  <31>  yrs   <5>   mos. [blank] ds. 
How long in U.S., 
if of foreign birth [blank] yrs [blank] mos. [blank] ds. 
______________________________________________________________________________ 
ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ 

[column 1 of 2] 
          Personal and Statistical Particulars 
______________________________________________________________________________ 
 3. Sex <Female>  4. Color or Race <White> 
 5. Single, Married, Widowed, or Divorced (write the word)  <Widowed> 
 5A. If Married, Widowed, or Divorced, 
     Husband of (or) Wife of <Elliott L. Story> 
 6. Date of Birth <February 7_ 1845> 19[blank; form too specific]
 7. Age    <78> Years <7> Months <7> Days 
 8. Occupation of Deceased 
  (a) Trade, profession, or particular kind of work 
  (b) General nature of industry, [text of 8a,b,c struck] 
  business, or establishment in 
  which employed (or employer)   <None, except> 
  (c) Name of employer           <household duties> 
______________________________________________________________________________ 
 9. Birthplace 
    (City or Town)     [blank] 
    (State or Country) <Southampton County, Va> 
______________________________________________________________________________ 
Parents 
10. Name of Father <Spratley L. Williams> 
11. Birthplace of Father 
    (City or Town)     [blank] 
    (State or Country) <Southampton County, Va> 
12. Maiden Name of Mother <Susan Frances Williford> 
13. Birthplace of Mother 
    (City or Town)     [blank] 
    (State or Country) <Southampton County, Va> 
______________________________________________________________________________ 
14. Informant <E. Frank Story> 
    (Address) <Franklin Va> 
______________________________________________________________________________ 
15. Filed <Oct 3[?]>, 19<23>   <C.C. Vaughan> 
                                      Registrar 
______________________________________________________________________________ 
ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ 

[column 2 of 2] 
          Medical Certificate of Death 
______________________________________________________________________________ 
16. Date of Death <Sept 14> 19<23> [date has been altered (overwritten)] 
17.        I Hereby Certify, That I Attended Deceased From 
    <Sept 1>, 19<19>, To  <Sept 14>, 19<23> 
    That I Last Saw H<er> Alive On <Sept 14>, 19<23> 
    And That Death Occured, On Date Stated Above, At <2_30 P>M. 
    The Cause of Death* Was As Follows: 
     <Angina Pectoris> 
               <89> 
                              Duration  [blank] Yrs. [blank] Mos. [blank] Ds. 
    Contributory <Artherio Sclerosis> 
      (Secondary)             Duration    <10>  Yrs. [blank] Mos. [blank] Ds. 

18. Where was disease contracted if not at place of death? <-> 
    Did an operation precede death? <no>  Date of [blank] 
    Was there an autopsy? <no> 
    What test confirmed diagnosis? <-> 

         (Signed) <Ashly Cutchins> M.D. 
    <9/17>, 19<23>  (Address)    <Franklin Va> 
    *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 
    <Family B. Grounds>                       <9/16>  19<23> 
20. Undertaker  <W.J.M. Holland> 
    Address    <Franklin Va> 
______________________________________________________________________________ 
ŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻŻ 
[document end] 

The Library of Virginia (LVA), Richmond, VA 
   Bureau Of Vital Statistics, Death Certificate 712-23538 


Additional information: 

Margaret's husband Elliott L. Story kept a series of diaries 1838-76, six 
   volumes of which are held by the Virginia Historical Society, and are 
   extensively cited in Daniel W. Crofts' "Old Southampton: Politics and 
   Society in a Virginia County, 1839-1869," (Charlottesville: University 
   Press of Virginia, 1992). 

Her obituary ("Tidewater News," Sep. 21, 1923, p. 1) is posted at: 
    http://files.usgwarchives.net/va/southampton/obits/s360m2ob.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/s360m1dc.txt