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Hunt, William (Always write with black ink) TRANSPORTATION OF CORPSE u. S. Form 36-6-10.29-30M. 1 PLACE OF DEATH CERTIFICATE OF DEATH COUNTY OF MAGISTERIAL HPnrjoo COMMONWEALTH OF VIRGINA DEPARTMENT OF HEALTH DISTRICT OF BUREAU OF VITAL STATISTICS OR III INC. TOWN OF REGISTRATION DISTRICT NO. REGISTERED NO. I OR (TO BE INSERTED BY REGISTRAR) (FOR USE OF LOCAL REGISTRAR) 1" CITY OF Richmond (No. 4210 Austa Ave. ST. WARD) IL (If death occurred in a hospital or other institution, give its TAME instead of street and number) 0 1 Length of residence in city or town where death occurred yrs mos. ds How long in U.S.,if of foreign birth? yrs. mos, ds '.. 2 FULL NAME William Jnhr Hunt O. I (A) RESIDENCE. NO. 4210 Augusta Ave. ST., WARD O 4 (Usual place of abode) • (If nonresident give city or town and State) U Iu PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH 0 3. SEX 4. COLOR OR RACE 5. SINGLE, MARRIED, WIDOWED, 21. DATE OF DEATH I— OR DIVORCED(WNte the word) (month, day, and year) Jr;,,1111,-.•1 r ? , Ic 4 U22. I HEREBY CERTIFY,THAT I ATTENDAD DECEASED FROM 0 Male White harried T [� a X W 5A. IF MARRIED, WIDOWED, OR DIVORCED D ••L+•u•+�-I�.e. 2.Q 1--�.�.J..c..('0 •••L1.G.-I•+ G., , 1-.�.t.ci-..i III r, HUSBAND OF I LAST SAW H �-1YLIVE ON •ti..G.. .L 1•• •+.y'�EATH IS SAID (OR) WIFE OF Edith B.Hunt ...' o . Z J TO HAVE OCCURRED ON THE DATE STATED ABOVE, AT J-L..t.1..D..A..._M. Q (l. 6. DATE OF BIRTH (month, day, and year) Oct.16,1863 THE PRINCIPAL CAUSE OF DEATH AND RELATED CAUSES OF IMPORTANCE IN tI) 7. AGE Years Months Days IF LESS THAN ORDER OF ONSET WERE AS FOLLOWS: f- t� i Date of onset ,. 2 l8 IA a mt DAY,MIN. HRS. _----- B. TRADE, PROFESSION, OR PARTICULAR T!� 1 z • KIND OF WORK DONE, AS SPINNER, Retired U ,.J i 0 SAWYER, BOOKKEEPER, ETC. .((� 'tt {{. n. u- U. Q 9. INDUSTRY OR BUSINESS IN WHICH - _pneumonia,} ti%-•�..u.t di...,4..t•L�-•L�-i.o PG. WORK WAS DONE, AS SILK MILL, SAW __af,•••,.(,L.Q•,.�;;�....lJ • cc � V MILL, BANK, ETC. CONTRIBUTORY CAUSES OF IMPORTANCE NOT RELATED TO Id < i U 10. DATE DECEASED LAST WORKED AT 11. TOTAL TIME (YEARS) PRINCIPAL CAUSE: U 0 THIS OCCUPATION (month and SPENT IN THIS j year) OCCUPATION (J) IL 12. BIRTHPLACE (city or town) Lake Cecrge. I- ::1,�ca.cr..cL. 1 ti F � -- (State or country) -_ -.- Ne Ya � - W d' NAME OF OPERATION one DATE OF Z U w 13. NAME Edgar Hunt O FZ., Y11 WHAT TEST CONFIRMED DIAGNOSIS?Ca k .UI iVOCERE AN AUTOPSY?.1Z0 < 14. BIRTHPLACE (city or town) ,r7 Z ec 4' (State or country) Unicnown 23. IF DEATH WAS DUE TO EXTERNAL CAUSES (VIOLENCE) FILL IN ALSO THE 0 FOLLOWING: DATE OF U w ACCIDENT, SUICIDE, OR HOMICIDE? INJURY 1 1::: 15. MAIDEN NAME Helen Dickinson IL S WHERE DID INJURY OCCUR? Q 4 O 16. BIRTHPLACE (city o town) �r� (Specify city or town, county, and State) 0 (State or Crountry) Unknown SPECIFY PLACE. INJURY OCCURRED IN.INDUSTRY, IN HOME, OR IN PUBLIC 0 17. INFORMANT Mr s,P,F,$wase-y Z (ADDRESS) 4210 Augusta Ave. MANNER OF INJURY W 18. BURIAL,1 CREMATION, OR REMOVALL /� Q NATURE OF INJURY IPLACE F.Q.r.t. . N (T t- - ..E.dwa .D ` - .. --. 24. WAS DISEASE OR INJURY IN ANY WAY RELATED TO OCCUPATION OF i- �t �T 19. UNDERTAKER ARW,.8ennet.t Co.ay..nc.. DECEASED? ivQ (ADDRESS) Rinhmonr, Tr.�.C IF SO, SPECIFY _. ____�e. 20. FILED , ti =�� ��L (SIGNED M. D, .;:z1.0 K�+-+� q Rrginrar. (ADDRESS) j+-Pv -t=s--- uE-'-n1kF-'-T 1 —' PERMIT OF STATE DEPARTMENT OF HEALTH OR REGISTRAR This Permit with above Certificate must be presented to Initial Baggage Agent and delivered with body at destination January 3„1933 , i • Permission is hereby granted to remove for burial atro= :E4I.wargt. N.a. • ..-.., the body of William John..-Hunt , above described, if prepared in accordance with the laws of this State, printed on the back of this permit. If contagious or communicable,state name of person who is authorized to accompany the body. Local Registrar,-Z'- . Detach above portion at this perforation and hand to passenger in charge, to be delivered to the undertaker at destination. If burial is made in this State the sexton or other person superintending must send this permit and certificate to the State Department of Health in ten days- unless burial is made in city or town where death certificates are permanently filed. Virginia Law for the Transportation of a Corpse ,g4. 0-e--etiK L.-we d (Code 1919, Section 1728) --Qat/14-1 ee f C 4r 3 II , Regulations Regarding the Transportation of the Dead RULE 1. A copy of the original death certificate on the be shipped to points in this State in tight ordinary casket standard certificate of death form, signed by attending boxes; and bodies addressed to the Anatomical Board of physician, permit of local board of health or registrar, and this State may he received for shipment when prepared in a transit label signed by the shipping funeral director, and such manner as the State Department of Health may direct. initial baggage agent, printed on strong white paper, sup- B. When the destination cannot be reached within plied through the State Department of Health by the pub- twenty-four hours after death, the body shall be thorough- lic printer, shall be required for the transportation by ly embalmed, and the coffin or casket placed in a strong, common carriers of bodies of persons dying in this State. well-made outside shipping case. The death certificate shall contain such information as is RULE 4. No distinterred body, dead from any disease required in the standard form of death certificate, if ob- or cause, shall be transported by common carriers, unless tainable. The health officer's or registrar's permit shall approved by health authorities having jurisdiction at the authorize the transportation of the body of the person place of disinterment, and a transit permit and transit described in the physician's certificate. The shipping label shall be required, as provided in Rule 1. The dis- funeral director shall state on the shipping label how the interment ,and transportation of bodies dead of diseases body is prepared, and the local baggage agent shall state mentioned in Rule 2 shall be not allowed except upon s ofe r , , e,onthe health authorities both hie__. _ i i __._._.... thereonthe route, rtame-and-adc'res_. -PC(`n �. �----.. �.ti _ of .. x,k c.c- rii�,i.� +.f"LTtIZ--. The physician's and health officer's or registrar's per- terment and the point of destination. All disinterred re- mit shall be given the escort, to be delivered with the mains for transportation shall be incased in metal casket body at destination. The shipping label shall be securely or metal lined boxes and hermetically sealed; but attached to the outside case. If the body is sent by ex- bodies in a receiving vault when prepared by licensed press, the physician's certificate and the permit shall be embalmer shall not be regarded as disinterred bodies attached to the express waybill and delivered with the until after the expiration of thirty days. body at the destination, and the shipping label shall be RULE 5. The outside case may be omitted in all in- attached to the outside case. stances when the body is transported in hearse or funeral RULE 2. The transportation of bodies dead of small- director's wagon. pox, plague, Asiatic cholera, yellow fever, typhus fever, ` RULE 6. Every outside case shall bear at least four diphtheria (membranous croup or diphtheritic sore throat), handles, and when over five feet six inches in length scarlet fever (scarlet rash or scarlatina), erysipelas, shall bear six handles. anthrax and leprosy shall be permitted only under the RULE 7. An approved disinfectant fluid shall contain following conditions: The body shall be thoroughly em- not less than five per cent, of formaldehyde gas; the term balmed with an approved disinfectant fluid, all orifices embalming as employed in these rules shall require the shall be closed with absorbent cotton, the body shall be injection by a licensed embalmer of not less than ten washed with the disinfectant fluid, enveloped in a sheet per cent, of the body weight for bodies of persons dead saturated with the same, and placed at once in the coffin of diseases in Rule 2, injected arterially, in addition to or casket, which shall be immediately closed, and the coffin cavity injection; and not less than six per cent, of the or casket, or the outside case containing the same, shall be body weight injected arterially in all other cases, in ad- metal or metal lined, and hermetically and permanently dition to cavity injection, and ten hours shall elapse be- sealed. tween the time of embalming and the shipment of the RULE 3. The transportation of bodies of any disease body. otlau.Shan those mentioned in Rule 2 shall be permitted RULE 8. The attached form of death certificate, faith under the following conditions: officer's or registrar's permit, and label as described here- A. When the destination can be reached within twenty- in, with these rules printed thereon, shall be used in this four hours after death, the coffin or casket shall be enclos- State for the shipment of bodies as herein provided. ed in a strong outside box made of sound lumber, not less RULE 9. Any violation of this act shall be deemed a than seven-eights of an inch thick, all joints must be misdemeanor and punishable by a fine of not less than tongued and grooved, top and bottom, put on with cleats ten nor more than twenty-five dollars for the first offense, or cross pieces, all put securely together, and be tightly and a fine of not less than twenty-five dollars nor more closed with white lead, asphalt varnish or paraffin paint, than fifty dollars, or imprisoned not exceeding thirty days, and a rubber gasket placed on the upper edge between the or both fined and imprisoned, in the discretion of the lid and box; but caskets containing embalmed bodies may court, for each additional offense.