Death ID:                    

Certificate Location:        
Certificate Number:          

Death Location:              
Death Address:               
Death Date:                  
Informant:                   



Name of Decedent:            
Immigrant ID:                OCNC-27NOV1913-3-C36-0010 
Sex:                         
Marital Status:              
Age (Birth Date):            
Occupation:                  
Home Address:                
Birth Place:                 
Residence Years:             

Name of Spouse:              
Immigrant ID:                KROO-12SEP1921-3-C15-0006 ROMA-07JAN1922-2-6-0007 

Name of Father:              
Immigrant ID:                
Birth Place:                 

Name of Mother:              
Immigrant ID:                
Birth Place:                 

Burial Place:                

Death Cause:
                             coronary occlusion, cardiac failure

Comments:
                             [also known as] Ghoogas Grjikian / wife's age: 43 years