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Death ID: Certificate Location: Certificate Number: Death Location: Death Address: Death Date: Informant: Name of Decedent: Immigrant ID: PATR-19JAN1901-0-11-0028 NYRK-02NOV1913-3-C4-0017 Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Name of Spouse: Immigrant ID: Name of Father: Immigrant ID: PATR-19JAN1901-0-11-0021 Birth Place: Name of Mother: Immigrant ID: PATR-19JAN1901-0-11-0022 NYRK-02NOV1913-3-C4-0016 Birth Place: Burial Place: Death Cause: appendicitis, acute suppurative, post-operative (contributory: septicemia, subacute)Comments: