| Registration Dist, No | 37-02 |
| Certificate Number | 3 |
| Home (usual residence) of Deceased | |
| State | NC |
| County | Gates |
| City or Town | Gates |
| Street or RFD | 1 |
| Is place of residence in corporate limits? | No |
| If foreign born, how long in USA? (years) | |
| Place of death | |
| County | Gates |
| Township | Haslett |
| City or town | Rural |
| Street, Hospital or Institution | |
| Length of stay in hosptial or Institution | |
| In this community (yrs. mos, or days) | 70(?) |
| Full Name | Ida Harrell Baker |
| If Veteran, Name War | |
| Social Security Number | |
| Sex | F |
| Color or race | W |
| Single, Married, Widowed or Divorced | Widowed |
| Name of husband or wife | John Holliday Baker |
| Age of husband or wife if alive (years) | |
| Birth date of deceased | Feb. 10, 1867 |
| Age (Years-Months-Days) | 76yrs 3mos 11dys |
| If less than one day (hrs. mins) | |
| Birthplace | Whaleyville, VA |
| Usual Occupation | Housewife |
| Industry or Business | |
| Father's name | John Thomas Harrell |
| Birthplace of father | Nansemond Co., VA |
| Mother's maiden name | Diana Gomer (?) |
| Birthplace of mother | Nansemond Co., VA |
| Date of death (Mon-day-year-time) | May, 21, 1943 7:45A |
| Physician attended to and from dates | From May 1941-May 21, 1943 |
| Last Seen | May 21, 1943 |
| Immediate cause of death | Cerebral Hemorhage |
| Duration | May 21, 1943 |
| Due to | Hypertension |
| Due to | |
| Other conditions | |
| Major findings of operations | |
| Of Autopsy | |
| Accident, suicide, or homicide | |
| Date of occurance | |
| Where did this injury occur? | |
| Place of injury | |
| At work? | |
| Means of injury | |
| Doctors signature | Jake A. Payne MD |
| Address | Sunbury |
| Date signed | May 21, 1943 |
| Informants signature | Roas B. Whitehurst |
| Address | Gates, NC |
| Burial, cremation or removal | Burial |
| Date | May 24, 1943 |
| cemetery | Family Cemetery |
| location | Gates Co., NC |
| Funeral director | R.W. Baker and Co. |
| address | Suffolk, VA |
| Filed | May 24, 1943 |
| Registrar | Mrs. A.C. Matthews |
| Comments | |
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