Page (PDF) | 5 |
---|---|
Certificate Number | 17801 |
Name of Deceased | Bivens, infant |
Place of Death | Somerset |
Town of Death | Pocomoke RFD |
Sex | boy |
Race | colored |
Married, Widowed, or Single | x |
Date of Birth | 11/11/1921 |
Age (year, month, days) | 9 ds |
Occupation or Employer | x |
Birthplace | Somerset |
Father's Name | Ira Bevans |
Father's Birthplace | Somerset |
Mother's Name | Ida Cottman |
Mother's Birthplace | Somerset |
Informant (Relationship and Address) | Renzie Waters; Pocomoke RFD |
Date of Death | 11/11/1921 |
Cause of Death and Time Attended by Doctor | falling of the head; no furth information; no physician |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | Samuel Scott; dep local reg |
Burial Place, Date, Undertaker, and Address | Tinleys; 11/12/1921; Ballard Bros; Pocomoke RFD |
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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