Page (PDF) | 69 |
---|---|
Certificate Number | 14123 |
Name of Deceased | Polk, Roscoe |
Place of Death | Wicomico |
Town of Death | Allen |
Sex | M |
Race | black |
Married, Widowed, or Single | single |
Date of Birth | 7/27/1914 |
Age (year, month, days) | 4 ds |
Occupation or Employer | child |
Birthplace | Allen |
Father's Name | Johny Polk |
Father's Birthplace | Maryland |
Mother's Name | Ne...? King |
Mother's Birthplace | Maryland |
Informant (Relationship and Address) | Henry Polk; Allen Md |
Date of Death | 8/1/1915 |
Cause of Death and Time Attended by Doctor | had no doctor & from information died from whooping cough |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | CR Truitt; Salisbury |
Burial Place, Date, Undertaker, and Address | Friend Ship Church yard Wicomico; 8/2/1910; Holloway & Co; Salisbury |
Length of Residence, Where Disease Contracted, Former Residence | 10 ds; lifetime Somerset |
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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