DEATH CERTIFICATE
Page 14
1st Part
| Column 1: Ledger Entry #: 9 |
|
Column 2: Date death reported and name of person reporting. |
| Dr. Kleiner ( Weiner ?) reported the death on 7 March (lll) 1934 |
| Column 3: Death details: |
| Time : / Day: 7 / Month: March / Year: 1934 / Place: Sokolow / House #: 385 |
| Column 4: Burial details: |
| Time : / Day: 9 / Month: March / Year: 1934 / Place: Sokolow |
| Column 5: Deceased |
| Sara Beller of Sokolow Place of death: Sokolow Residence: Sokolow / House #: 385 |
2ed Part
| Column 6 Gender |
|
Female |
| Column 7: Age: |
| Year: 1 / Month 3 ( child 1 and 3 month old) |
| Column 8: Status |
| Single / wife / widow: non applicable |
| Column 9: |
| Disease / cause of death: Pneumonia |
| Column 10: Remarks: |
| blank |
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