Page (PDF) | 5 |
---|---|
Certificate Number | 36091 |
Name of Deceased | Blake, John Lee |
Place of Death | Worcester |
Town of Death | Pocomoke |
Sex | M |
Race | colored |
Married, Widowed, or Single | single |
Date of Birth | don't know |
Age (year, month, days) | abt 40 yrs |
Occupation or Employer | labor - odd jobs |
Birthplace | Va |
Father's Name | James Selby |
Father's Birthplace | Va |
Mother's Name | Tobiatha Blake |
Mother's Birthplace | don't know |
Informant (Relationship and Address) | Mattie Holland; Pocomoke City |
Date of Death | 12/8/1917 |
Cause of Death and Time Attended by Doctor | likely consumption as he died with hemorrhage from lungs |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | NE Sartorius; Pocomoke Md |
Burial Place, Date, Undertaker, and Address | Halls Hill #1; 12/10/1917; Chas H Ballard & 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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