| Page (PDF) | 3 |
|---|---|
| Certificate Number | 11917 |
| Name of Deceased | Ballard, Rome |
| Place of Death | Somerset |
| Town of Death | Marion |
| Sex | M |
| Race | col |
| Married, Widowed, or Single | single |
| Date of Birth | not known |
| Age (year, month, days) | abt 40 |
| Occupation or Employer | laborer |
| Birthplace | Somerset |
| Father's Name | Levin Ballard |
| Father's Birthplace | not known |
| Mother's Name | Mary Hendry |
| Mother's Birthplace | Maryland |
| Informant (Relationship and Address) | Jechess? Davis; Marion Md |
| Date of Death | 7/28/1917 |
| Cause of Death and Time Attended by Doctor | hypstatis pneumonia; cardiac exhaustion |
| Immediate, Secondary, or Contributory Cause and How Long | general arterio sclerosis |
| Physician and Address | George C Coulbourn; Marion Md |
| Burial Place, Date, Undertaker, and Address | Kingston; 7/29/1917; Tilghman & Ward; Marion |
| 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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