Page (PDF) | 17 |
---|---|
Certificate Number | 11915 |
Name of Deceased | Coulbourne, Miss Lottie |
Place of Death | Somerset |
Town of Death | Lawsonia Md |
Sex | F |
Race | negro |
Married, Widowed, or Single | single |
Date of Birth | 2/6/1900 |
Age (year, month, days) | 15 yrs t mos 14 ds |
Occupation or Employer | school girl |
Birthplace | Lawsonia Md |
Father's Name | James Coulbourne |
Father's Birthplace | Md |
Mother's Name | Ella Tull |
Mother's Birthplace | Md |
Informant (Relationship and Address) | Ella Williams; Lawsonia, Md |
Date of Death | 7/20/1915 |
Cause of Death and Time Attended by Doctor | tuberculosis of lungs |
Immediate, Secondary, or Contributory Cause and How Long | peritonitis; 1 ds |
Physician and Address | WJ Barkley; 309 W Md Ave |
Burial Place, Date, Undertaker, and Address | Asbury Cemetary; 7/21/1915; Garnett Brown; Crisfield |
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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