Death ID:                    

Certificate Location:        
Certificate Number:          

Death Location:              
Death Address:               
Death Date:                  
Informant:                   

Name of Decedent:            
Immigrant ID:                FUMR-11JUL1921-3-177-0005 
Sex:                         
Marital Status:              
Age (Birth Date):            
Occupation:                  
Home Address:                
Birth Place:                 
Residence Years:             

Name of Spouse:              
Immigrant ID:                MNDS-19FEB1928-3-C25-0027 

Name of Father:              
Immigrant ID:                
Birth Place:                 

Name of Mother:              
Immigrant ID:                MNDS-24DEC1923-3-0-0425 
Birth Place:                 

Burial Place:                

Death Cause:
                             heat exhaustion (collapsed at work)

Comments:
                             [also known as] Haigoz Sirounian / wife's age: 34 years