Full Name: Addie Davis
Certificate Number: C-49486
Date of Death: December 15, 1911
Gender: Female
Race: Colored
Marital Status: S
Age at Death: about 54
Place of Birth: Cambridge, Maryland
Place of Death: Provident Hospital
Primary Cause of Death: Arteri-Sclerosis, Myocarditis, Pulmonary Edema, unable to state
Father’s Name: Do? Davis, Maryland
Mother’s Maiden Name: Cer? Small, Maryland
Occupation: Cook
Date of Burial: 12/17/1911
Informant: Mrs. Matilda Dais, 317 W Preston St
Undertaker: Felix B Pye, Sr, 102 E Mulberry St
Death Record Series ID: CM1132-111.xlsx
Last Residence: 24th St, 1 W
Notes: Gastritis (Chronic Catarrh??)
