| Page (PDF) | 19 |
|---|---|
| Certificate Number | 16603 |
| Name of Deceased | Foreman, [not named] |
| Place of Death | Worcester |
| Town of Death | Welbourne |
| Sex | F |
| Race | colored |
| Married, Widowed, or Single | single |
| Date of Birth | 9/2/1917 |
| Age (year, month, days) | – |
| Occupation or Employer | none |
| Birthplace | Worcester |
| Father's Name | Luthur Foreman |
| Father's Birthplace | Maryland |
| Mother's Name | Connie? Wise |
| Mother's Birthplace | Maryland |
| Informant (Relationship and Address) | Luethur Foreman; Wellbourne Md |
| Date of Death | 9/2/1917 |
| Cause of Death and Time Attended by Doctor | uraemis poisoning. Born dead |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | AF Wood; Greenbackville, Va |
| Burial Place, Date, Undertaker, and Address | Old St Paul Cemetary; 9/4/1917; HA Covington; New Church Va |
| 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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