Page (PDF) | 87 |
---|---|
Certificate Number | 15745 |
Name of Deceased | Waters, Ada Louise |
Place of Death | Somerset |
Town of Death | Upper Fairmount |
Sex | F |
Race | negro |
Married, Widowed, or Single | single |
Date of Birth | 9/22/1884 |
Age (year, month, days) | 33 yrs 10 mos 14 ds |
Occupation or Employer | house work; private family |
Birthplace | Upper Fairmount, Md |
Father's Name | Stephen Waters |
Father's Birthplace | Pocomoke City, Md. |
Mother's Name | Marcellerin Beckett |
Mother's Birthplace | Upper Fairmount |
Informant (Relationship and Address) | Ethel Waters; Upper Fairmount Md |
Date of Death | 8/6/1918 |
Cause of Death and Time Attended by Doctor | pellagra; abt 3 mos |
Immediate, Secondary, or Contributory Cause and How Long | exhaustion; 1 mos |
Physician and Address | Wj Barkley; 309 W Md Ave |
Burial Place, Date, Undertaker, and Address | Greenmount Cemetery; 8/8/1918; Herbert Wilson; Up Fairmount |
Length of Residence, Where Disease Contracted, Former Residence | 33 yrs; 10 mos 14 ds; Upper Fairmount |
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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