| Page (PDF) | 17 |
|---|---|
| Certificate Number | 8560 |
| Name of Deceased | Elzey, Infant |
| Place of Death | Somerset |
| Town of Death | Champ |
| Sex | F |
| Race | Colored |
| Married, Widowed, or Single | X |
| Date of Birth | 5/27/1917 |
| Age (year, month, days) | X |
| Occupation or Employer | X |
| Birthplace | Champ, Md |
| Father's Name | Fred Elzey |
| Father's Birthplace | Champ, Md |
| Mother's Name | Jane Jones |
| Mother's Birthplace | Oriole, Md |
| Informant (Relationship and Address) | Fred Elzey; Champ, Md |
| Date of Death | 5/27/1017 |
| Cause of Death and Time Attended by Doctor | Still born |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | Wm. S. Bennett, Local Registrar, Oriole, Md |
| Burial Place, Date, Undertaker, and Address | Camp, Md 5/28/1917 Fred Elzey, Camp, 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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