Death ID:                    

Certificate Location:        
Certificate Number:          

Death Location:              
Death Address:               
Death Date:                  
Informant:                   



Decedent Name:               
Immigrant ID:                LSVO-13JUN1908-3-12-0006 
Sex:                         
Marital Status:              
Age (Birth Date):            
Occupation:                  
Home Address:                
Birth Place:                 
Residence Years:             

 

Spouse Name:                 
Immigrant ID:                PENN-05JAN1906-3-1-0016 HUDS-27APR1906-3-3-0003 LSNE-10SEP1909-3-8-0005 



Father Name:                 
Immigrant ID:                CANA-03JAN1923-3-15-0001 
Birth Place:                 

Mother Name:                 
Immigrant ID:                LSVO-13JUN1908-3-12-0005 
Birth Place:                 

Burial Place:                

Death Cause:
                             coronary thrombosis

Comments:
                             husband's age: 57 years