Death Certificate, VA, Arlington, Robert T Bryan Jr 1974 COMMONWEALTH OF VIRGINIA – CERTIFICATE OF DEATH DEPARTMENT OF HEALTH — BUREAU OF VITAL RECORDS AND HEALTH STATISTICS — RICHMOND REGISTRATION CERTIFICATE STATE FILE AREA NUMBER 106 NUMBER 852 NUMBER 74-034927 1. FULL NAME OF DECEASED (first) (middle) (last) ROBERT T. BRYAN JR 2. SEX male female [x] [ ] 3. DATE OF DEATH (mo) (day) (year) Nov. 21 1974 4. AGE OF DECEASED 82 years 5. COLOR OR RACE Cauc. 6. NAME OF HOSPITAL OR (if none, so state) INSTITUTION OF DEATH No. VA Drs. Hospital 7. COUNTY OF DEATH(if independent city, leave blank) Arlington 8. CITY OR TOWN (if rural, so state) inside city or town limits? yes no [ ] [ ] 9. STREET A DRESS OR RT. NO. OF DEATH ,OF PLACE OF DEATH 601 S. Carlin Springs Road 10. STATE (OR FOREIGN COUNTRY) OF DECEASED’S RESIDENCE Virginia 11. COUNTY OF DECEASED’S (if independent city, leave blank) Arlington 12. CITY OR TOWN inside city or town limits? Yes No [ ] [ ] 13. STREET ADDRESS OR RT. NO. OF RESIDENCE 4301 Columbia Pike Apt. 435 Page 1 of 3 ** PAGE BREAK ** Death Certificate, VA, Arlington, Robert T Bryan Jr 1974 ZIP CODE 22204 14. NAME OF FATHER OF DECEASED ROBERT T. BRYAN, SR. l5. MAIDEN NAME OF DECEASED’S LULU FREELAND 16. DECEASED CITIZEN OF WHAT COUNTRY USA 17. MARRIED [X] NEVER MARRIED [ ] WIDOWED [ ] DIVORCED [ ] 18. IF MARRIED OR WIDOWED, NAME OF SPOUSE IF DIVORCED LEAVE BLANK GERTRUDE I. BRYAN 19. (BLANKED OUT) 20. IF VETERAN, name war, or if peacetime only, so state No 21. BIRTHPLACE (state or coutry) China 22. DATE OF BIRTH (mo.) (day) (year) Oct. 13, 1892 23. USUAL OR LAST OCCUPATION Retired 24. KIND OF BUSINESS OR INDUSTRY Lawyer 25. INFORMANT OR SOURCE OF INFORMATION GERTRUDE I. BRYAN 26. CAUSE OF DEATH (Enter only one cause per line) INTERVAL IMMEDIATE CAUSE (A) Shock 2 days DUE TO (B) Pneumonia 3 days DUE TO (C) Severe Parkinson’s Disease 6 months DATE 11/21/1974 Page 2 of 3 ** PAGE BREAK ** Death Certificate, VA, Arlington, Robert T Bryan Jr 1974 ###### # # ##### ####### # # ##### ####### # # # # ## ## # # # ## # # # # # ## ## # # # # # # # # # # # # # # # # # # ###### # # # # #### ##### # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## ### # # # # # # ###### # # ##### ####### # # ### ##### ####### # # Transcribed from original documents by Brent R. Brian & Martha M. Brian. This document and others can be found on our website: BMGEN We claim COPYLEFT on the documents that we publish that are our original work. COPYLEFT “rules” can be reviewed on the web site: GNU Free Documentation License In short, use what you like. But if you use our stuff, mention us as the source. Brent R. Brian Martha M. Brian BrianMitchellGenealogy@gmail.com Page 3 of 3 ** PAGE BREAK **