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REGISTRATION DISTRICT NO. LOCAL FILE NUMBER STATE OF ILLINOIS CERTIFICATE OF DEATH STATE FILE NUMBER 2. SEX 5c. UNDER 1 DAY 3. DATE OF DEATH (Month/Day/Year) (Spell Month) 1. DECEDENT'S LEGAL NAME (Include AKAs if any) (First, Middle, Last) 4. COUNTY OF DEATH 7a. CITY OR TOWN 5a. AGE AT LAST BIRTHDAY (Years) 5b. UNDER 1 YEAR Months Days Hours Minutes 6. DATE OF BIRTH (Month/Day/Year) 7b. HOSPITAL OR OTHER...
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