| Page (PDF) | 17 |
|---|---|
| Certificate Number | 6387 |
| Name of Deceased | Jackson, James W |
| Place of Death | Worcester |
| Town of Death | Stockton |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | single |
| Date of Birth | 3/30/1921 |
| Age (year, month, days) | 9 ds |
| Occupation or Employer | none |
| Birthplace | Maryland |
| Father's Name | John H Jackson |
| Father's Birthplace | maryland |
| Mother's Name | Velie Wise |
| Mother's Birthplace | Virginia |
| Informant (Relationship and Address) | John H Jackson; Girdletree Md |
| Date of Death | 4/10/1921 |
| Cause of Death and Time Attended by Doctor | n physician. Seemed sick 3 or 4 days and took convulsions & died |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | WO Payne, regt. Stockton Md |
| Burial Place, Date, Undertaker, and Address | Cool Springs Cemetary; 4/11/1921; Rowley & Purnell; Stockton |
| 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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