| Page (PDF) | 43 |
|---|---|
| Certificate Number | 7063 |
| Name of Deceased | Jackson [not named] |
| Place of Death | Somerset |
| Town of Death | Marion |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | infant |
| Date of Birth | 7/2/1914 |
| Age (year, month, days) | 14 ds |
| Occupation or Employer | x |
| Birthplace | Md |
| Father's Name | Anvillis Jackson |
| Father's Birthplace | Md |
| Mother's Name | Sarah Gordy |
| Mother's Birthplace | Md |
| Informant (Relationship and Address) | Dan Gordy; Marion |
| Date of Death | 7/16/1914 |
| Cause of Death and Time Attended by Doctor | no dr in attendance; exhaustion due to health? |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | FT Adams - |
| Burial Place, Date, Undertaker, and Address | Watters Cemetery; 7/16/1914; AW Dixon; Monie |
| 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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