Confidential Yes No

 






City is a Township/City City Township Unknown
Residence Inside City/Township Yes No Unknown
SEX Male Female Unknown
Hispanic Origin Yes No Unknown


Birth Information
Place of Death Information
Was death inside city limits Yes No Unknown

Relations

Edit Relations

 
HISPANIC ORIGIN
 

RelationshipTypes(you may select more than one)





Death Certificate Applicant/Receiver









 
EDUCATION














HISPANIC ORIGIN









MARITAL STATUS




Widowed

Divorced

Never Married

Unknown
 
×

Non-Standard Entry