Name of Deceased: Elease Autry Fullwood
Date of Death: 10-22-70
Sex: F
Color or Race: W
State of Birth: N.C.
Date of Birth: 22 Nov. 1915
Age: 54 years
Place of Death: County: Brunswick. City/Town: Southport. Name of Hospital/Insitution: 202 E. Bay Street. Inside city limits
Usuall Residence: State: NC. County: Brunswick. City/Town: Southport. Street Address: 202 E. Bay Street. Inside City limits.
Widowed
Father's Name: George Autry
Mother's Maiden Name: Rebecca Smith Autry
Informant's Name/Address: Mrs. C.M. Anderson. 202 E. Bay Street, Southport, NC
Cause of Death: Probable Heart Attack
No. Autopsy
Death occurred at 10:00pm.
Signature of Certifier: Lowell B. Bennett, Coroner.10-23-70, Shallotte NC.
Burial: 10-24-70. Antioch Cemeetery, Bolivia N.C.
Funeral Home: Gilbert's Funeral Service, Southport, N.C.
Signature of Funeral Director: G.E. Gilbert, License # 778
Date Rec'd by local Reg: 10-24-70.
Signature of Registrar: John R. Ba???
Signature of Embalmer: G.E. Gilbert. License #619