Death Certificate of Crutchlow, Mary

Mary Crutchlow, a 77-year-old woman, was born on 17 Jan 1837 in
Southampton to Dickey Gray and Eliza Bryant. She died in Capron,
Southampton County, Virginia, on 31 Jan 1914. No physician was present
at the time of death and he died of Bowel Constipation, She was likely
buried in Southampton County. Informant was C. A. Outlaw of Petersburg,
Va.

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| Field                                                                               | Value                  |
|-------------------------------------------------------------------------------------|------------------------|
| PLACE OF DEATH. County of                                                           | Southampton            |
| District of                                                                         | Boykins                |
| Inc. Town of                                                                        | Capron                 |
| Registration District No.                                                           | 71                     |
| File No.                                                                            | 2160                   |
| 2. FULL NAME                                                                        | Mary Crutchlow         |
| 3. SEX                                                                              | Woman                  |
| 4. COLOR OR RACE                                                                    | White                  |
| 5. SINGLE, MARRIED, WIDOWED, OR DIVORCED                                            | Widowed                |
| 6. DATE OF BIRTH                                                                    | 17 Jan 1837            |
| 7. AGE                                                                              | 77 yrs 1 day           |
| 8. OCCUPATION                                                                       | [blank]                |
| 9. BIRTHPLACE (State or Country)                                                    | Southampton            |
| 10. NAME OF FATHER                                                                  | Dickey Gray            |
| 11. BIRTHPLACE OF FATHER (State or Country)                                         | Southampton            |
| 12. MAIDEN NAME OF MOTHER                                                           | Eliza Bryant           |
| 13. BIRTHPLACE OF MOTHER (State or Country)                                         | Southampton            |
| 14. THE ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE (Informant)                       | C.A. Outlaw            |
| Address                                                                             | Petersburg, Va.        |
| 15. Filed                                                                           | 2 Feb 1914             |
| LOCAL REGISTRAR                                                                     | G.W. Bryant            |
| 16. DATE OF DEATH                                                                   | 31 Jan 1914            |
| 17. I HEREBY CERTIFY, That I attended deceased from                                 | [No Dr]                |
| to                                                                                  | [blank]                |
| that I last saw her alive on                                                        | [blank]                |
| and that death occurred, on the date stated above, at                               | [blank]                |
| The CAUSE OF DEATH was as follows                                                   | Bowel Constipation     |
|| (Duration)                                                                         | [blank]                |
| Contributory (Secondary)                                                            | [blank]                |
|| (Duration)                                                                         | [blank]                |
| (Signed)                                                                            | Boswell Compton        |
| M.D.                                                                                | [blank]                |
| 18. LENGTH OF RESIDENCE (For Hospitals, Institutions, Transients,orrecentResidents) | [blank]                |
| 19. PLACE OF BURIAL OR REMOVAL                                                      | [blank]                |
| DATE OF BURIAL                                                                      | 1 Feb 1914             |
| 20. UNDERTAKER                                                                      | O. W. Gray & Bro.      |
| ADDRESS                                                                             | Boykins, Va.           |
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