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Death ID: Certificate Location: Certificate Number: Death Location: Death Address: Death Date: Informant: Decedent Name: Immigrant ID: GERM-10JAN1913-3-7-0029 Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Spouse Name: Immigrant ID: Father Name: Immigrant ID: Birth Place: Mother Name: Immigrant ID: Birth Place: Burial Place: Death Cause: hemorrhage & shock from fractured ribs, left side, fractured left clavicle which punctured left lung, caused by being struck by automobile on Hershey Boulevard east end of HersheyComments: Exhibits: