Death Certificate of John Bradshaw

John Bradshaw, 83, died on 12 May 1922 in Windsor, Isle of Wight County,
Virginia County from acute endocarditis due to acute indigestion. He was
married and was buried on 13 May 1922 at Beaverdam Church.

Mr. Bradshaw was a farmer born in Virginia, son of Jordon Bradshaw and
Bettie Johnson. His father and mother were both born in Virginia. The
informant for his death was P. C. Bradshaw.

|------------------------------------------------------------------------|
| Field                                    | Value                       |
|------------------------------------------|-----------------------------|
| 1. COUNTY OF                             | Isle of Wight County        |
| 1. MAGISTERIAL DISTRICT OR               | White                       |
| 1. CITY OR TOWN                          | Windsor                     |
| 2. FULL NAME                             | John Bradshaw               |
| 3.RESIDENCE                              | [blank]                     |
| 4. How long in U.S., if of foreign birth | [blank]                     |
| 5. SEX                                   | Male                        |
| 6. COLOR OR RACE                         | White                       |
| 7. SINGLE, MARRIED, WIDOWED OR DIVORCED  | Married                     |
| 8. DATE OF BIRTH                         | [blank]                     |
| 9. AGE                                   | 83 years                    |
| 10. OCCUPATION OF DECEASED               | Farmer                      |
| 11. NAME OF EMPLOYER                     | [blank]                     |
| 12. BIRTHPLACE                           | Va                          |
| 13. NAME OF FATHER                       | Jordon Bradshaw             |
| 14. BIRTHPLACE OF FATHER                 | Va                          |
| 15. MAIDEN NAME OF MOTHER                | Bettie Johnson              |
| 16. BIRTHPLACE OF MOTHER                 | Va                          |
| 14. INFORMANT                            | P. C. Bradshaw              |
| 15. Filed                                | May 17, 1922                |
| 16. DATE OF DEATH                        | May 12, 1922                |
| 17. I ATTENDED DECEASED FROM             | May 8, 1922 to May 12, 1922 |
| 17. That I last saw him alive on         | May 11, 1922                |
| 18. THE CAUSE OF DEATH                   | Acute Endocarditis          |
|--                                        | 20 days                     |
| CONTRIBUTORY                             | Acute Indigestion           |
|--                                        | 2 days                      |
| 18. WHERE WAS DISEASE CONTRACTED?        | [blank]                     |
| OPERATION PRECEDED DEATH?                | [blank]                     |
| DATE OF                                  | [blank]                     |
| WAS THERE AN AUTOPSY?                    | [blank]                     |
| WHAT TEST CONFIRMED DIAGNOSIS?           | [blank]                     |
| Signature                                | Gavin Rawls, M.D.           |
| Address                                  | Carrsville                  |
| Place of burial, cremation, or removal   | Beaverdam Church            |
| Date of Burial                           | May 13, 1922                |
| Undertaker                               | W J M Holland               |
|------------------------------------------------------------------------|

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