| Page (PDF) | 23 |
|---|---|
| Certificate Number | 16605 |
| Name of Deceased | Formon, Susan M |
| Place of Death | Worcester |
| Town of Death | near Snow Hill |
| Sex | F |
| Race | col |
| Married, Widowed, or Single | married |
| Date of Birth | 9/18/1852 |
| Age (year, month, days) | 65 yrs 12 mos 23 ds |
| Occupation or Employer | house wife |
| Birthplace | Worcester |
| Father's Name | Ned Nock |
| Father's Birthplace | Worcester |
| Mother's Name | Catherine Sselby |
| Mother's Birthplace | Worcester |
| Informant (Relationship and Address) | Lemuel Forman; Snow Hill Md |
| Date of Death | 9/23/1917 |
| Cause of Death and Time Attended by Doctor | woman was dead when I arrived there, never saw her alive; others said to have had a bad heart |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | Arthur B Landers; Snow Hil |
| Burial Place, Date, Undertaker, and Address | MT Westly Cemetery; 9/25/1917; William S Williams; Snow Hill |
| 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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