| Page (PDF) | 93 |
|---|---|
| Certificate Number | 43216 |
| Name of Deceased | Polk, Pearl |
| Place of Death | Somerset |
| Town of Death | near Pr Anne |
| Sex | F |
| Race | black |
| Married, Widowed, or Single | single |
| Date of Birth | 10/4/1918 |
| Age (year, month, days) | 1 yrs |
| Occupation or Employer | Md |
| Birthplace | Md |
| Father's Name | Walter Polk |
| Father's Birthplace | Md |
| Mother's Name | Lula Cannon |
| Mother's Birthplace | Md |
| Informant (Relationship and Address) | Lula Cannon Polk; Pr Anne RD1 |
| Date of Death | 11/3/1918 |
| Cause of Death and Time Attended by Doctor | no dr attended child from history of case; broncho perforation was cause of death |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | TJ Smith (not in attendance); Pr Anne |
| Burial Place, Date, Undertaker, and Address | St Marys Church; 11/4/1918; Jas I Dennis; Pr Anne |
| 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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