| Page (PDF) | 13 |
|---|---|
| Certificate Number | 9859 |
| Name of Deceased | Custis, baby |
| Place of Death | Wicomico |
| Town of Death | near Mardela |
| Sex | F |
| Race | black |
| Married, Widowed, or Single | single |
| Date of Birth | 6/20/1921 |
| Age (year, month, days) | 1 ds |
| Occupation or Employer | x |
| Birthplace | Md |
| Father's Name | Louis Custis |
| Father's Birthplace | VA |
| Mother's Name | Lizzie Rider |
| Mother's Birthplace | dm |
| Informant (Relationship and Address) | Louis Custis; Mardela Spgs, Md |
| Date of Death | 6/20/1921 |
| Cause of Death and Time Attended by Doctor | no physician in attendance; congenital debility |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | WH Robertson; local registrar; x |
| Burial Place, Date, Undertaker, and Address | Mardela Springs; 6/21/1921; no undertaker; x |
| 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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