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Death ID: Certificate Location: Certificate Number: Death Location: Death Address: Death Date: Informant: Decedent Name: Immigrant ID: ROUS-24OCT1920-3-19-0029 Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Spouse Name: Immigrant ID: Father Name: Immigrant ID: ROUS-24OCT1920-3-19-0027 Birth Place: Mother Name: Immigrant ID: ROUS-24OCT1920-3-19-0028 Birth Place: Burial Place: Death Cause: 1st & 2nd degree burns to back & arms due to pail of hot water tipping overComments: