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Death ID: Certificate Location: Certificate Number: Death Location: Death Date: Informant: Name of Decedent: Immigrant ID: Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Name of Spouse: Immigrant ID: Name of Father: Immigrant ID: LTRN-21OCT1912-3-11-0029 Birth Place: Name of Mother: Immigrant ID: CHGO-29JUL1913-3-11-0018 Birth Place: Burial Place: Death Cause: influenzaComments: