Page (PDF) | 21 |
---|---|
Certificate Number | 6176 |
Name of Deceased | Johnson, Addie |
Place of Death | Somerset |
Town of Death | Fairmount |
Sex | F |
Race | negro |
Married, Widowed, or Single | single |
Date of Birth | 8/4/1908 |
Age (year, month, days) | 12 yrs 8 mos 17 ds |
Occupation or Employer | none |
Birthplace | Maryland |
Father's Name | Wm M Johnson |
Father's Birthplace | Maryland |
Mother's Name | Ella Fields |
Mother's Birthplace | Maryland |
Informant (Relationship and Address) | Alphonso Johnson; Fairmount Md |
Date of Death | 4/21/1921 |
Cause of Death and Time Attended by Doctor | tuberculosis of lungs; 1 yrs |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | GE Dickinson; Upper Fairmouynt |
Burial Place, Date, Undertaker, and Address | Centennial Church Yd; 4/23/1921; Herbert Wilson; Up Fairmount |
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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