| Page (PDF) | 15 |
|---|---|
| Certificate Number | 1369 |
| Name of Deceased | Forman, Annie |
| Place of Death | Worcester |
| Town of Death | near Snow Hill |
| Sex | F |
| Race | col |
| Married, Widowed, or Single | single |
| Date of Birth | 1/6/1918 |
| Age (year, month, days) | – |
| Occupation or Employer | none |
| Birthplace | Snow Hill Md |
| Father's Name | Hessel Dennis |
| Father's Birthplace | Snow Hill Md |
| Mother's Name | Clara Fomon |
| Mother's Birthplace | Snow Hill Md |
| Informant (Relationship and Address) | James e Richardson; Snow Hill Md R1 |
| Date of Death | 1/6/1918 |
| Cause of Death and Time Attended by Doctor | dead born; 7 mos baby |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | LeRoy Smith, L Reg.; Snow Hill |
| Burial Place, Date, Undertaker, and Address | MT Westley Cemetery; 1/7/1917 [1918] |
| 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.
Pinned records can be viewed at any time by clicking the More menu in the top right corner of the page, then selecting My Pinned Records.