Page (PDF) | 69 |
---|---|
Certificate Number | 14726 |
Name of Deceased | Waters, Hazel Virginia |
Place of Death | Somerset |
Town of Death | near Pocomoke City |
Sex | F |
Race | colored |
Married, Widowed, or Single | single |
Date of Birth | 7/28/1915 |
Age (year, month, days) | 2 yrs 28 ds |
Occupation or Employer | at home |
Birthplace | Somerset |
Father's Name | Gladstone Henry Waters |
Father's Birthplace | Somerset |
Mother's Name | Rosie Della Long |
Mother's Birthplace | Virginia |
Informant (Relationship and Address) | Gladstone H Waters; Pocomoke Md |
Date of Death | 8/25/1917 |
Cause of Death and Time Attended by Doctor | acute intestinal intoxication; 15 ds |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | NE Sartorius; Pocomoke City |
Burial Place, Date, Undertaker, and Address | Watson Cemetary; 8/26/1917; Stevenson Bros; 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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