| Page (PDF) | 33 |
|---|---|
| Certificate Number | 19038 |
| Name of Deceased | Jackson, Cleo |
| Place of Death | Wicomico |
| Town of Death | Salisbury; PG Hospital |
| Sex | F |
| Race | colored |
| Married, Widowed, or Single | single |
| Date of Birth | 1906 |
| Age (year, month, days) | abt 11 yrs |
| Occupation or Employer | none |
| Birthplace | Maryland |
| Father's Name | Wm Jackson |
| Father's Birthplace | Maryland |
| Mother's Name | Annie M Collins |
| Mother's Birthplace | VA |
| Informant (Relationship and Address) | Wm Jackson; Princess Anne; Md |
| Date of Death | 10/8/1917 |
| Cause of Death and Time Attended by Doctor | gun shot wound in chest and abdomen (accidental); 6 hrs |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | IB Potter; Salibury |
| Burial Place, Date, Undertaker, and Address | Princess Anne Md; 10/10/1917; James I Dennis; Crisfield Anne Md |
| Length of Residence, Where Disease Contracted, Former Residence | 5 hrs; residence Princess Anne |
| 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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