Page (PDF) | 11 |
---|---|
Certificate Number | – |
Name of Deceased | Collick, Samuel |
Place of Death | Worcester |
Town of Death | Stockton |
Sex | M |
Race | Black |
Married, Widowed, or Single | single |
Date of Birth | - |
Age (year, month, days) | 9 weeks |
Occupation or Employer | - |
Birthplace | Maryland |
Father's Name | John H. Collick |
Father's Birthplace | Virginia |
Mother's Name | Hattie Rowley |
Mother's Birthplace | Maryland |
Informant (Relationship and Address) | John H. Collick Girdletree, Md |
Date of Death | 10/21/1912 |
Cause of Death and Time Attended by Doctor | caught on fire by accident in room with children & fire took place. No doctor attended died in a few hours after burned. |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | none |
Burial Place, Date, Undertaker, and Address | Cool Springs Cemetery 10/23/1912 Rowley & Purnell Stockton, 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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