Full Name: Samuel Moore
Certificate Number: C-44009
Date of Death: May 25, 1911
Gender: Male
Race: Black
Marital Status: M
Age at Death: 1852/03/04 59
Place of Birth: Maryland
Place of Death: Pear Alley, 923
Primary Cause of Death: Rheumatic fever with Acute Interstitial Nephritis
Father’s Name: Thomas J Moore
Mother’s Maiden Name: —
Occupation: Livery Stable Driver
Date of Burial: 5/27/1911
Informant: Emma? G Moore, 923 Pear Alley
Undertaker: Charles E Franch, 802 Madison Ave
Death Record Series ID: CM1132-109.xlsx
