| Page (PDF) | 5 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Bloxom, David |
| Place of Death | Wicomico |
| Town of Death | Salisbury |
| Sex | M |
| Race | Colored |
| Married, Widowed, or Single | S |
| Date of Birth | 1903 |
| Age (year, month, days) | 8 yrs |
| Occupation or Employer | none |
| Birthplace | Accomac Co. VA |
| Father's Name | Geo. Bloxom |
| Father's Birthplace | Accomac Co., VA |
| Mother's Name | Henrietta Rayfield |
| Mother's Birthplace | Accomac Co., Va |
| Informant (Relationship and Address) | J.W. F. Dick, Salisbury, Md |
| Date of Death | 1/9/1911 |
| Cause of Death and Time Attended by Doctor | Perforation of stomach and liver by 38 calibre pistol ball causing hemorrhage |
| Immediate, Secondary, or Contributory Cause and How Long | Loss of blood, few hours |
| Physician and Address | McF Dick, Salisbury, Md |
| Burial Place, Date, Undertaker, and Address | James F. Stewart. Salisbury, Md |
| Length of Residence, Where Disease Contracted, Former Residence | Length of residence at place of death - 7 1/2 hours In the state - 7 1/2 hrs Where was disease contracted if not at place of death - Tacoma C-4 Va Former of usual residence - Accomac Co. VA |
| Other Notes | accident |
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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