| Page (PDF) | 9 |
|---|---|
| Certificate Number | 25968 |
| Name of Deceased | Collins, Samuel |
| Place of Death | Worcester |
| Town of Death | Stockton |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | married |
| Date of Birth | don't know |
| Age (year, month, days) | abt 23 yrs |
| Occupation or Employer | laborer by day |
| Birthplace | Maryland |
| Father's Name | Joseph Collins |
| Father's Birthplace | Maryland |
| Mother's Name | Eva Justice |
| Mother's Birthplace | Maryland |
| Informant (Relationship and Address) | Jacob Collins; Stockton |
| Date of Death | 11/24/1917 |
| Cause of Death and Time Attended by Doctor | no physician attended; died of tuberculosis supposed |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | WO Payne; Stockton Md |
| Burial Place, Date, Undertaker, and Address | Old St Paul Cemetery; 11/26/19817; FA Covington; New Church Va |
| 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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