Full Name: Jerome Smith
Certificate Number: D-57769
Date of Death: October 13, 1921
Gender: Male
Race: Colored
Marital Status: M
Age at Death: 1890 30
Place of Birth: Maryland
Place of Death: McCulloh St, 1726
Primary Cause of Death: Homicide- Revolver shot wound in head
Father’s Name: Nathaniel Smith, Martyland
Mother’s Maiden Name: Georgianna Warner, Maryland
Occupation: Chauffeur
Date of Burial: 10/17/1921
Informant: Bessie Rasin, 2118 McCulloh St
Undertaker: George T A Gibson, 513 Laurens St
Death Record Series ID: CM1132-146.xlsx
