| Page (PDF) | 17 |
|---|---|
| Certificate Number | 11915 |
| Name of Deceased | Coulbourne, Miss Lottie |
| Place of Death | Somerset |
| Town of Death | Lawsonia Md |
| Sex | F |
| Race | negro |
| Married, Widowed, or Single | single |
| Date of Birth | 2/6/1900 |
| Age (year, month, days) | 15 yrs t mos 14 ds |
| Occupation or Employer | school girl |
| Birthplace | Lawsonia Md |
| Father's Name | James Coulbourne |
| Father's Birthplace | Md |
| Mother's Name | Ella Tull |
| Mother's Birthplace | Md |
| Informant (Relationship and Address) | Ella Williams; Lawsonia, Md |
| Date of Death | 7/20/1915 |
| Cause of Death and Time Attended by Doctor | tuberculosis of lungs |
| Immediate, Secondary, or Contributory Cause and How Long | peritonitis; 1 ds |
| Physician and Address | WJ Barkley; 309 W Md Ave |
| Burial Place, Date, Undertaker, and Address | Asbury Cemetary; 7/21/1915; Garnett Brown; Crisfield |
| 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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