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Death ID: Certificate Location: Certificate Number: Death Location: 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: LEOP-05NOV1920-2-6-0002 Birth Place: Mother Name: Immigrant ID: PANN-11AUG1920-3-60-0001 Birth Place: Burial Place: Death Cause: premature birth at 6½ mo[nths]Comments: acting undertaker: K. M. Zahigian