| Page (PDF) | 39 |
|---|---|
| Certificate Number | 9962 |
| Name of Deceased | Puckham, (still born) |
| Place of Death | Somerset |
| Town of Death | Upper Fairmount |
| Sex | F |
| Race | black |
| Married, Widowed, or Single | single |
| Date of Birth | 7/2/1919 |
| Age (year, month, days) | still born |
| Occupation or Employer | none |
| Birthplace | Maryland |
| Father's Name | Amos Puckham |
| Father's Birthplace | Maryland |
| Mother's Name | Adelle Maddox |
| Mother's Birthplace | Maryland |
| Informant (Relationship and Address) | Adelle Maddox; Upper Fairmount |
| Date of Death | 7/2/1919 |
| Cause of Death and Time Attended by Doctor | still born; premature |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | GE Dickinson; Upper Fairmount |
| Burial Place, Date, Undertaker, and Address | Upper Fairmount; 7/3/1919; John H Maddox; Up Fairmount |
| 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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