Dept of Public Welfare Division of Public Health Form/& 17
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FORM H4
Department of Public Welfare ---Division of Public Health
Office of the Local Registrar Vital Statistics
MINNEAPOLIS, MINNESOTA
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CITY HALL 620%1941
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A Certifiut. as Required by law Hariat RMMa Filed, P.rmi.abp u Her. by Granted for the Roper Di.IN dt/oa of the Remaim of:
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NAME Grace Hart Aspden SEX Female AGE 72
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PLACE OF DEATH Eitel Roepital
DATE OF DEATH 6/191961 NATIVITY Minn. SOC. ST. Married
CAUSE OF DEATH Adeno carcinoma of sigmoid
MED. ATTENDANT S. L. Arey
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DISPOSITION Chanhassen Cam., Chanhassen Twp., MinrDATE 6/22/1941
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FUNERAL DIR. E.E. Bardeell NO. ADDRE5 - Excelsior, Minn.
PERMIT �� a
NO. +{
111 COMMISSIONER OF'MCALTH INCLOCAL R IeTRM
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