Marshal Sullivan Death Certificate-- July 22, 1926 DIVISION OF HEALTH SERVICES-VITAL RECORDS BRANCH

Marshal Sullivan -- July 22, 1926

(Transcribed by David B Dunn) B.V.S. FORM 11 NORTH CAROLINA STATE BOAD OF HEALTH 195 BUREAU OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH 1. PLACE OF DEATH: County: Duplin Registration Dist. No. 315388 Registrar No. 15 Township: Kenansville 2. FULL NAME: Marshal Sullivan (a) Residence: Blank PERSONAN AND STATISTICAL PARTICULARS 3. SEX: Male 4. COLOR: White 5. Marital status: Married 5a Wife: Blank 6. DATE OF BIRTH : Blank 7. AGE: 66 YEARS 11 MONTHS 20 DAYS 8. TRADE: Farmer 8a. PLACE WHERE TRADE IS DONE: Blank 8b General nature of Occupation: Blank 8c. NAME OF EMPLOYER: blank 9. BirthPlace: Wolfscrape Township,Duplin County N.C. 10. FATHERS NAME: Elisha Sullivan 11. BIRTHPLACE OF FATHER: Duplin County N.C. 12. MOTHERS MADEN NAME: Nancy Jane Blalock 13.BIRTH PLACE OF MOTHER: N. C. 14 INFORMANT: C. J Brock Kenansville, N.C. 15. D. N. Brock Registrar MEDICAL CERTIFICATE OF DEATH 16. DATE OF DEATH: July 22, 1926 17. I HEREBY CERTIFY, That I attended deceased from Blank to Blank I last saw him alive Blank. Death is said to have Occurred on the date stated above, at Blank pm. The principle Cause of death and related causes of importance in order of Onset were as follows: Died Sudden no medical treatment 19. PLACE OF BURIAL, CREMATION, OR REMOVAL: O’Daniel Graveyard July 23, 1926 20. Undertaker: C. J. Brock Kenansville, N.

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