| Page (PDF) | 19 |
|---|---|
| Certificate Number | 16089 |
| Name of Deceased | Jackson, Otho |
| Place of Death | Worcester |
| Town of Death | Girdletree |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | single |
| Date of Birth | 1/12/1912 |
| Age (year, month, days) | 8 yrs 8 mos 15 ds |
| Occupation or Employer | none |
| Birthplace | Cool Springs |
| Father's Name | Sam Jackson |
| Father's Birthplace | Girdletree, Md |
| Mother's Name | Lena Collick |
| Mother's Birthplace | Girdletree Md |
| Informant (Relationship and Address) | Samuel Jackson; Girdle tree |
| Date of Death | 10/8/1921 |
| Cause of Death and Time Attended by Doctor | pneumonia; broncho; 8 ds |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | SC Oglesby; Girdletree Md |
| Burial Place, Date, Undertaker, and Address | Scoolspring Cem; 10/4/1921; WS Williams; Snow Hill 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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