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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: STLO-10JUN1912-3-C2-0016 OLMP-12JUN1912-3-C35-0005 Birth Place: Name of Mother: Immigrant ID: SAXO-18FEB1923-3-UC3-0002 Birth Place: Burial Place: Death Cause: defective organs (contributory: malnutrition)Comments: