Certificate of Death

Serena Ballard

Registration Dist, No 37-00
Certificate Number 3
Home (usual residence) of Deceased  
State NC
County Gates
City or Town  
Street or RFD RFD
Is place of residence in corporate limits? No
If foreign born, how long in USA? (years)  
Place of death  
County Gates
Township Hall
City or town Eure, NC
Street, Hospital or Institution  
Length of stay in hosptial or Institution  
In this community (yrs. mos, or days)  
Full Name Serena Ballard
If Veteran, Name War  
Social Security Number  
Sex F
Color or race C
Single, Married, Widowed or Divorced Married
Name of husband or wife Heber Ballard
Age of husband or wife if alive (years) 56yrs
Birth date of deceased  
Age (Years-Months-Days) 60yrs 10mos
If less than one day (hrs. mins)  
Birthplace Scotland Neck, NC
Usual Occupation Domestic
Industry or Business  
Father's name Smith
Birthplace of father Unknown
Mother's maiden name Unknown
Birthplace of mother Unknown
Date of death (Mon-day-year-time) July 17, 1947 11:30pm
Physician attended to and from dates July 3, 1947-July 17, 1947
Last Seen July 17, 1947
Immediate cause of death Hypostatic pneumonia due to apoplexy
Duration 2 dys
Due to Hypertensive cardiac vascular disease
Due to For 7 yrs
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 Parish B. Cleveland
Address Gatesville, NC
Date signed July 18, 1947
Informants signature L. Heber Ballard X (signed with mark)
Address Eure, NC
Burial, cremation or removal Burial
Date  
cemetery Cross Cemetery
location Eure, NC
Funeral director A.L. Weaver
address Winton, NC
Filed 7-8-1947
Registrar P.B. Cleveland
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