Death ID:                    

Certificate Location:        
Certificate Number:          

Death Location:              
Death Address:               
Death Date:                  
Informant:                   

Name of Decedent:            
Immigrant ID:                PANN-09NOV1912-3-T1-0009 SUSQ-02JUN1920-3-18-0017 
Sex:                         
Marital Status:              
Age (Birth Date):            
Occupation:                  
Home Address:                
Birth Place:                 
Residence Years:             

Name of Spouse:              
Immigrant ID:                SUSQ-02JUN1920-3-18-0018 

Name of Father:              
Immigrant ID:                
Birth Place:                 

Name of Mother:              
Immigrant ID:                
Birth Place:                 

Burial Place:                

Death Cause:
                             pulmonary tuberculosis (contributory: pleuritis)

Comments:
                             wife [also known as] Shakey O'Hannassian / filed in Vol. 43, p. 192