Full Name: Richard H Churchville
Certificate Number: C-38608
Date of Death: December 1, 1910
Gender: Male
Race: Colored
Marital Status: M
Age at Death: 44
Place of Birth: Maryland
Place of Death: Jefferson St, 1521
Primary Cause of Death: A Miliary Tuberculosis about 2 weeks
Father’s Name: Richard Churchville, Maryland
Mother’s Maiden Name: —
Occupation: Cook on sailing vessel
Date of Burial: 12/3/1910
Informant: Mary Churchville, 1521 Jefferson St
Undertaker: Robert A Elliott, 506 Rogers Ave
Death Record Series ID: CM1132-107.xlsx
Notes: Exhaustion
