Family Record Sheet

Father

Born
Died

Mother

Name
Born
Died
NameRosa Matilda Burcham
Born
Died

Spouse

BornApril 5, 1871
 in Surry County, North Carolina, 
DiedMay 4, 1959
 in Amelia County, Virginia, 

Marriage Information

Date
Place

Spouse's Father

BornOctober 19, 1838
 in Surry County, North Carolina, 
Died
 in Carroll County, Virginia, 

Spouse's Mother

BornOctober 14, 1836
 in Surry County, North Carolina, 
Died
 in Surry County, North Carolina, 

Children

Name Gender Birth Date Birth Place