| Page (PDF) | 51 |
|---|---|
| Certificate Number | 22937 |
| Name of Deceased | Van Buren?, [nameless] |
| Place of Death | Somerset |
| Town of Death | Dames Quarter |
| Sex | F |
| Race | B |
| Married, Widowed, or Single | S |
| Date of Birth | 12/27/1916 |
| Age (year, month, days) | x |
| Occupation or Employer | x |
| Birthplace | Md |
| Father's Name | Harvey Van Buren |
| Father's Birthplace | Md |
| Mother's Name | Elizabeth Roxbury |
| Mother's Birthplace | Md |
| Informant (Relationship and Address) | Elizabeth Van Buren; Dames Quarter |
| Date of Death | 12/27/1916 |
| Cause of Death and Time Attended by Doctor | premature birth cause unknown |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | EP Simpson; Chance |
| Burial Place, Date, Undertaker, and Address | Dames Quarter; 12/27/1916; Frank Smith; Dames !/4 |
| 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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