Record #4573 from Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922

Page (PDF)	61
Certificate Number	6108
Name of Deceased	Waller, Willis
Place of Death	Wicomico
Town of Death	Salisbury; P G Hospital
Sex	M
Race	collord
Married, Widowed, or Single	married
Date of Birth	2/11/1894
Age (year, month, days)	25 yrs 2 mos 15 ds
Occupation or Employer	laborer
Birthplace	Delaware
Father's Name	James L Waller
Father's Birthplace	Delaware
Mother's Name	Sarah Thomas
Mother's Birthplace	Delaware
Informant (Relationship and Address)	Mary Waller; Laurel Del
Date of Death	4/26/1919
Cause of Death and Time Attended by Doctor	scalded (accidental)
Immediate, Secondary, or Contributory Cause and How Long	general shock & exhaustion; 7 ds
Physician and Address	JMcF Dick; Salisbury Md
Burial Place, Date, Undertaker, and Address	Mt Peace Laurel Del; 4/28/1919; EB JHO Riggin; Laurel Del
Length of Residence, Where Disease Contracted, Former Residence	7 ds; residence Laurel Del
Other Notes	–

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[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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