| Page (PDF) | 35 |
|---|---|
| Certificate Number | – |
| Name of Deceased | Mills, Sam'l |
| Place of Death | Somerset |
| Town of Death | Near Pr Anne |
| Sex | M |
| Race | Black |
| Married, Widowed, or Single | Single |
| Date of Birth | 9/9/1911 |
| Age (year, month, days) | 21 days |
| Occupation or Employer | - |
| Birthplace | Somerset Co |
| Father's Name | Wm Mills |
| Father's Birthplace | Someret Co |
| Mother's Name | Mary Whitney |
| Mother's Birthplace | Somerset Co |
| Informant (Relationship and Address) | Gertrude Whitney, Princess Anne |
| Date of Death | 9/29/1911 |
| Cause of Death and Time Attended by Doctor | No Physician in attendance - Cholur Sifaulin, 3 days |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | T J Smith, M.D., Pr Anne |
| Burial Place, Date, Undertaker, and Address | Princess Anne 9/20/1911 James I Dennis undertaker, 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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