| Page (PDF) | 21 |
|---|---|
| Certificate Number | x |
| Name of Deceased | Fassitt, Paulliane |
| Place of Death | Worcester |
| Town of Death | Berllin |
| Sex | F |
| Race | Col |
| Married, Widowed, or Single | - |
| Date of Birth | 8/22/1912 |
| Age (year, month, days) | 2 mos 14 ds |
| Occupation or Employer | x |
| Birthplace | Maryland |
| Father's Name | Clayton Tassitt |
| Father's Birthplace | Berlin |
| Mother's Name | Sicle Forcan? |
| Mother's Birthplace | Berlin |
| Informant (Relationship and Address) | Julia Fassitt |
| Date of Death | 11/6/1912 |
| Cause of Death and Time Attended by Doctor | No Dr. in attendance |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | S B Jones |
| Burial Place, Date, Undertaker, and Address | St. Pauls Cemetery 11/7/1912 J. W. Burbage & Bro Berlin Md |
| Length of Residence, Where Disease Contracted, Former Residence | – |
| Other Notes | – |
If you are citing this record, please use the following format:
[Author (if known)], Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922, [Date (if known)], Enduring Connections: Exploring Delmarva’s Black History, Nabb Research Center, Salisbury University.
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