Death ID:                    

Certificate Location:        
Certificate Number:          

Death Location:              
Death Address:               
Death Date:                  
Informant:                   

Name of Decedent:            
Immigrant ID:                TNMR-26DEC1918-3-26-0001 
Sex:                         
Marital Status:              
Age (Birth Date):            
Occupation:                  
Home Address:                
Birth Place:                 
Residence Years:             

 

Name of Spouse:              
Immigrant ID:                TNMR-26DEC1918-3-26-0002 

Name of Father:              
Immigrant ID:                
Birth Place:                 

Name of Mother:              
Immigrant ID:                
Birth Place:                 

Burial Place:                

Death Cause:
                             thrombosis of r[igh]t coronary artery due to coronary arteriosclerosis

Comments:
                             [information was obtained from Coroner's Register, Dec-1949, #2191]