| Page (PDF) | 11 |
|---|---|
| Certificate Number | 5357 |
| Name of Deceased | Burnett, Ulusses |
| Place of Death | Somerset |
| Town of Death | near Pr Anne |
| Sex | M |
| Race | col |
| Married, Widowed, or Single | single |
| Date of Birth | abt 17 |
| Age (year, month, days) | 17 yrs |
| Occupation or Employer | farm laborer |
| Birthplace | Pa |
| Father's Name | 7l7sses Burnett |
| Father's Birthplace | Md |
| Mother's Name | Ida Maddox |
| Mother's Birthplace | Md |
| Informant (Relationship and Address) | Chas Burkhead; Pr Anne Md |
| Date of Death | 3/9/2920 |
| Cause of Death and Time Attended by Doctor | broncho pneumonia |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | TJ Smith; Pr Anne Md |
| Burial Place, Date, Undertaker, and Address | Union; 3/11/1920; James I Dennis; Pr Anne 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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