| Page (PDF) | 149 |
|---|---|
| Certificate Number | 1731 |
| Name of Deceased | Waller, Chas Henry |
| Place of Death | Wicomico |
| Town of Death | Mardela |
| Sex | M |
| Race | col |
| Married, Widowed, or Single | single |
| Date of Birth | 1865 |
| Age (year, month, days) | 54 yrs |
| Occupation or Employer | laborer |
| Birthplace | Md |
| Father's Name | John Waller |
| Father's Birthplace | Md |
| Mother's Name | Margret Deashield |
| Mother's Birthplace | Md |
| Informant (Relationship and Address) | Cineliar Waller; Mardela Md |
| Date of Death | 1/14/1919 |
| Cause of Death and Time Attended by Doctor | x |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | x |
| Burial Place, Date, Undertaker, and Address | John Westly Church; 1/15/1919; Al Seabrease; Mardela Md |
| 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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