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Death ID: Certificate Location: Certificate Number: Death Location: Death Address: Death Date: Informant: Decedent Name: Immigrant ID: Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Spouse Name: Immigrant ID: Father Name: Immigrant ID: MADO-12JUL1913-3-6-0002 Birth Place: Mother Name: Immigrant ID: ROCH-14OCT1913-3-10-0007 Birth Place: Burial Place: Death Cause: fracture of skull, duration few min. (accidentally struck by cake of ice falling from ice wagon)Comments: