| Page (PDF) | 3 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Barclay, Infant |
| Place of Death | Somerset |
| Town of Death | Mt. Vernon |
| Sex | M |
| Race | Colored |
| Married, Widowed, or Single | S |
| Date of Birth | 3/28/1911 |
| Age (year, month, days) | 2 days |
| Occupation or Employer | Infant |
| Birthplace | Somerset Co |
| Father's Name | Bennie Barclay |
| Father's Birthplace | Somerst Co |
| Mother's Name | Susie Jones |
| Mother's Birthplace | Somerset |
| Informant (Relationship and Address) | Bennie Barclay P Anne Route #2 |
| Date of Death | 3/30/1911 |
| Cause of Death and Time Attended by Doctor | Premature Birth |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | H A Barnes MD, Princes Anne, Md Route #2 |
| Burial Place, Date, Undertaker, and Address | Mt Vernon 3/31/1911 Dashiell Bros undertaker P Anne, 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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