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Death ID: Certificate Location: Certificate Number: Death Location: Death Address: Death Date: Informant: Decedent Name: Immigrant ID: OBDM-19OCT1896-3--0120 Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Spouse Name: Immigrant ID: LSVO-26NOV1904-3-M-0028 Father Name: Immigrant ID: Birth Place: Mother Name: Immigrant ID: Birth Place: Burial Place: Death Cause: pyelitis (contributory: uremia)Comments: [age & birth date are inconsistent]