| Page (PDF) | 17 |
|---|---|
| Certificate Number | 10416 |
| Name of Deceased | Gillett, Saml J |
| Place of Death | Worcester |
| Town of Death | Pocomoke |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | infant |
| Date of Birth | 2/1/1917 |
| Age (year, month, days) | 4 mos 12 ds |
| Occupation or Employer | infant |
| Birthplace | Somerset |
| Father's Name | John Jackson |
| Father's Birthplace | Somerset |
| Mother's Name | Edith Gillett |
| Mother's Birthplace | Worcester |
| Informant (Relationship and Address) | Saml Gillett; Pocomoke |
| Date of Death | 6/12/1917 |
| Cause of Death and Time Attended by Doctor | acute indigestion and probably convultions, I did not see child prescribed for it on Saturday Jun 9th |
| Immediate, Secondary, or Contributory Cause and How Long | bottle fed |
| Physician and Address | Fred Quinn; Pocomoke |
| Burial Place, Date, Undertaker, and Address | Slocomb Farm VA near New Church; 6/14/1917; CH Ballard & Bro; Pocomoke |
| 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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