Full Name: George V Jackson
Certificate Number: C-43960
Date of Death: May 21, 1911
Gender: Male
Race: Colored
Marital Status: S
Age at Death: 19
Place of Birth: Maryland
Place of Death: Municipal Tuberculosis Hospital
Primary Cause of Death: Exhaustion
Father’s Name: Charles Jackson, Maryland
Mother’s Maiden Name: India Jackson, Maryland
Occupation: Waiter
Date of Burial: 5/25/1911
Informant: Lamar Hollyday, Superintendent, Bay View Asylum
Undertaker: Robert A Elliott, 506 Rogers Ave
Death Record Series ID: CM1132-109.xlsx
Notes: Pulmonary Phthisis
