| Page (PDF) | 87 |
|---|---|
| Certificate Number | 15745 |
| Name of Deceased | Waters, Ada Louise |
| Place of Death | Somerset |
| Town of Death | Upper Fairmount |
| Sex | F |
| Race | negro |
| Married, Widowed, or Single | single |
| Date of Birth | 9/22/1884 |
| Age (year, month, days) | 33 yrs 10 mos 14 ds |
| Occupation or Employer | house work; private family |
| Birthplace | Upper Fairmount, Md |
| Father's Name | Stephen Waters |
| Father's Birthplace | Pocomoke City, Md. |
| Mother's Name | Marcellerin Beckett |
| Mother's Birthplace | Upper Fairmount |
| Informant (Relationship and Address) | Ethel Waters; Upper Fairmount Md |
| Date of Death | 8/6/1918 |
| Cause of Death and Time Attended by Doctor | pellagra; abt 3 mos |
| Immediate, Secondary, or Contributory Cause and How Long | exhaustion; 1 mos |
| Physician and Address | Wj Barkley; 309 W Md Ave |
| Burial Place, Date, Undertaker, and Address | Greenmount Cemetery; 8/8/1918; Herbert Wilson; Up Fairmount |
| Length of Residence, Where Disease Contracted, Former Residence | 33 yrs; 10 mos 14 ds; Upper Fairmount |
| 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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