| Page (PDF) | 3 |
|---|---|
| Certificate Number | 789 |
| Name of Deceased | Anderson, Jim M |
| Place of Death | Somerset |
| Town of Death | Deals Island |
| Sex | M |
| Race | Black |
| Married, Widowed, or Single | Single |
| Date of Birth | 2/12/1905 |
| Age (year, month, days) | 7 yrs 9 mos 7 ds |
| Occupation or Employer | School boy |
| Birthplace | Somerset Co Md |
| Father's Name | James H. Anderson |
| Father's Birthplace | Somerset Co Md |
| Mother's Name | Susie E. Robinson |
| Mother's Birthplace | Somerset Co Md |
| Informant (Relationship and Address) | Susie E. Anderson, mother |
| Date of Death | 1/3/1913 |
| Cause of Death and Time Attended by Doctor | acute general tubercalis; I made investigation no physician |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | Geor B Homer; acting Coronor; Deals Island |
| Burial Place, Date, Undertaker, and Address | Deal's Island, Md; 1/3/1913; t.W. Handy; Deals island Md |
| Length of Residence, Where Disease Contracted, Former Residence | family complaint; Deals island |
| 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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