Record #772 from Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922

Page (PDF)	51
Certificate Number	–
Name of Deceased	Waller, Chas Wesley
Place of Death	Wicomico
Town of Death	Salisbury
Sex	M
Race	Cold
Married, Widowed, or Single	Single
Date of Birth	7/28/1912
Age (year, month, days)	38 yr 8 mos
Occupation or Employer	Laborer
Birthplace	Md Wicomico
Father's Name	James Waller
Father's Birthplace	Md
Mother's Name	Emily Haney
Mother's Birthplace	Md
Informant (Relationship and Address)	Hicks Waller, Mardela Md
Date of Death	3/26/1912
Cause of Death and Time Attended by Doctor	mill explosion - internal injuries and left thigh mangled, 4 hours
Immediate, Secondary, or Contributory Cause and How Long	–
Physician and Address	D B Potter, M.D., Salisbury, Md
Burial Place, Date, Undertaker, and Address	Mardela Md 3/29/1912A L Seabrase? undertaker, Mardela, Md
Length of Residence, Where Disease Contracted, Former Residence	–
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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