Page (PDF) | 77 |
---|---|
Certificate Number | 15904 |
Name of Deceased | [Wallace], nameless |
Place of Death | Somerset |
Town of Death | Wenona |
Sex | M |
Race | B |
Married, Widowed, or Single | single |
Date of Birth | 10/30/1916 |
Age (year, month, days) | 30 minutes |
Occupation or Employer | x |
Birthplace | Md |
Father's Name | Robert Wallace |
Father's Birthplace | Md |
Mother's Name | Rosina Costen |
Mother's Birthplace | Md |
Informant (Relationship and Address) | Rosina Wallace; Wenona |
Date of Death | 10/30/1916 |
Cause of Death and Time Attended by Doctor | premature birth, 5th month |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | EP Simpson; Chance Md |
Burial Place, Date, Undertaker, and Address | Deals Island; 10/31/1916; LG Webster; Deals Island |
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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