| Page (PDF) | 11 |
|---|---|
| Certificate Number | 2424 |
| Name of Deceased | no name still born infant |
| Place of Death | Worcester |
| Town of Death | Berlin RD, Md |
| Sex | M |
| Race | Col |
| Married, Widowed, or Single | x |
| Date of Birth | 2/27/1913 |
| Age (year, month, days) | none |
| Occupation or Employer | none |
| Birthplace | Md |
| Father's Name | Wm Fooks |
| Father's Birthplace | Berlin, Md |
| Mother's Name | Daisy Davis |
| Mother's Birthplace | Berlin, Md |
| Informant (Relationship and Address) | Ebe Holland; Berlin Md |
| Date of Death | 2/27/1913 |
| Cause of Death and Time Attended by Doctor | dead born; at least 30 days before birth |
| Immediate, Secondary, or Contributory Cause and How Long | syphilis |
| Physician and Address | Ebe Holland; Berlin Md |
| Burial Place, Date, Undertaker, and Address | Private burying 2/27/1913 |
| 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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