| Page (PDF) | 5 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Ballard, Carrie |
| Place of Death | Somerset |
| Town of Death | Princess Anne |
| Sex | F |
| Race | colored |
| Married, Widowed, or Single | S |
| Date of Birth | – |
| Age (year, month, days) | 20 |
| Occupation or Employer | servant |
| Birthplace | Maryland |
| Father's Name | John Ballard |
| Father's Birthplace | - |
| Mother's Name | Ester Ballard |
| Mother's Birthplace | - |
| Informant (Relationship and Address) | Hutt Costen - |
| Date of Death | 6/20/1910 |
| Cause of Death and Time Attended by Doctor | some broncchol? trouble, has been living in city quite a white hasn't had physician since returning home |
| Immediate, Secondary, or Contributory Cause and How Long | - |
| Physician and Address | F. J. Smith, Princess Anne |
| Burial Place, Date, Undertaker, and Address | – |
| 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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