| Page (PDF) | 29 |
|---|---|
| Certificate Number | 4259 |
| Name of Deceased | Johnson, child not named |
| Place of Death | Worcester |
| Town of Death | near Pocomoke; Musinville? |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | x |
| Date of Birth | 2/2/1916 |
| Age (year, month, days) | 1 mos 16 ds |
| Occupation or Employer | x |
| Birthplace | Worcester |
| Father's Name | Christopher Johnson |
| Father's Birthplace | Maryland |
| Mother's Name | Martha E Coulbourne |
| Mother's Birthplace | Worcester |
| Informant (Relationship and Address) | Joseph Coulbourne; Pocomoke |
| Date of Death | 3/17/1916 |
| Cause of Death and Time Attended by Doctor | child was sick 3 days not knowing it was danger, very sick; no physician called |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | Charles S Day; Pocomoke |
| Burial Place, Date, Undertaker, and Address | ? Near Pocomoke; 3/18/1916; CH Ballard; Pocomoke |
| 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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