| Page (PDF) | 79 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Waters, Hardelia |
| Place of Death | Somerset |
| Town of Death | Fairmount, Md |
| Sex | F |
| Race | Blk |
| Married, Widowed, or Single | S |
| Date of Birth | 12/1/1896 |
| Age (year, month, days) | 14 yrs 1 mos 7 days |
| Occupation or Employer | - |
| Birthplace | Somerset |
| Father's Name | Alexander Waters |
| Father's Birthplace | Somerset |
| Mother's Name | Aurelia Maddox |
| Mother's Birthplace | Somerset |
| Informant (Relationship and Address) | Edward D. Waters, Upper Fairmount, Md |
| Date of Death | 1/7/1911 |
| Cause of Death and Time Attended by Doctor | Tuberculosis 6 mos |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | G.E. Dickinson, M.D. Upper Fairmount |
| Burial Place, Date, Undertaker, and Address | Centenial Cemetery, Jan 7, 1911, H.S. Wilson, undertaker Up Fairmont, Md |
| 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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