Page (PDF) | 93 |
---|---|
Certificate Number | 43216 |
Name of Deceased | Polk, Pearl |
Place of Death | Somerset |
Town of Death | near Pr Anne |
Sex | F |
Race | black |
Married, Widowed, or Single | single |
Date of Birth | 10/4/1918 |
Age (year, month, days) | 1 yrs |
Occupation or Employer | Md |
Birthplace | Md |
Father's Name | Walter Polk |
Father's Birthplace | Md |
Mother's Name | Lula Cannon |
Mother's Birthplace | Md |
Informant (Relationship and Address) | Lula Cannon Polk; Pr Anne RD1 |
Date of Death | 11/3/1918 |
Cause of Death and Time Attended by Doctor | no dr attended child from history of case; broncho perforation was cause of death |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | TJ Smith (not in attendance); Pr Anne |
Burial Place, Date, Undertaker, and Address | St Marys Church; 11/4/1918; Jas I Dennis; Pr Anne |
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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