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Death ID: Certificate Location: Certificate Number: Death Location: Death Date: Informant: Name of Decedent: Immigrant ID: CHGO-29AUG1911-3-8-0006 Sex: Marital Status: Age (Birth Date): Occupation: Home Address: Birth Place: Residence Years: Name of Spouse: Immigrant ID: CHGO-29AUG1911-3-8-0007 Name of Father: Immigrant ID: Birth Place: Name of Mother: Immigrant ID: Birth Place: Burial Place: Death Cause: chronic myocarditis (contributory: arteriosclerosis)Comments: