| Page (PDF) | 69 |
|---|---|
| Certificate Number | 14726 |
| Name of Deceased | Waters, Hazel Virginia |
| Place of Death | Somerset |
| Town of Death | near Pocomoke City |
| Sex | F |
| Race | colored |
| Married, Widowed, or Single | single |
| Date of Birth | 7/28/1915 |
| Age (year, month, days) | 2 yrs 28 ds |
| Occupation or Employer | at home |
| Birthplace | Somerset |
| Father's Name | Gladstone Henry Waters |
| Father's Birthplace | Somerset |
| Mother's Name | Rosie Della Long |
| Mother's Birthplace | Virginia |
| Informant (Relationship and Address) | Gladstone H Waters; Pocomoke Md |
| Date of Death | 8/25/1917 |
| Cause of Death and Time Attended by Doctor | acute intestinal intoxication; 15 ds |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | NE Sartorius; Pocomoke City |
| Burial Place, Date, Undertaker, and Address | Watson Cemetary; 8/26/1917; Stevenson Bros; Pocomoke |
| 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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