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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: INDI-05AUG1909-3-17-0002 Birth Place: Mother Name: Immigrant ID: BELV-03AUG1922-2-7-0023 MJST-12JUL1927-3-UC3-0009 Birth Place: Burial Place: Death Cause: pertussis (contributory: diarrhea & enteritis)Comments: