North Carolina State Board of Health Bureau Of Vital Statistics Standard Certificate of Death Place of Death - County: Forsyth State- N.C. City- Winston- Salem If death occurred in Hospital or Institution- Memorial Hospital Full Name: Bertha Beal Residence: 2510 Sunnyside Avenue Personal And Statistical Particulars Sex: Female - Color or Race: White - Single, Married, Widowed or Divorced: Married If married, widowed or divorced, Husband or Wife of: G.W. Beal Date of Birth: May 21 1893 Age: 33 years 2 months 8 days Occupation of deceased: Domestic Birthplace: South Carolina Name of Father B.J. Troutman Name of Mother: Ida Williams Birthplace of Father: South Carolina Birthplace of Mother: South Carolina Informant: Mr. G.W. Beal Address: City Filed- 8-2-1926 Registar: R.L. Carlton, M.D. Medical Certification of Death Date of Death: July 29 1926 I hereby certify, That I attended deceased from July 23 1926 to July 29, 1926 that I last saw her alive on July 29 1926 and that death occurred on the date stated above at 1 p.m. The cause of Death was as follows: Lobar Pneumonia Signed: A.C. Masten, M.D. 7-30-1926 Winston-Salem, N.C. Place of Burial: Union Ridge Date of Burial: 7-31-1926 Undertaker: Vogler & Sons Address: City