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Get VA VS2 2004-2021

BER 1. FULL NAME OF DECEDENT 3. DATE OF DEATH STATE FILE NUMBER (first) (mo) (day) (middle) (year) (last) 4. AGE IF UNDER 1 YEAR years PLACE OF DEATH months DOA USUAL RESIDENCE OF DECEDENT inside city or town limits? yes no 11. STATE (OR FOREIGN COUNTRY) OF DECEDENT'S RESIDENCE PERSONAL DATA OF DECEDENT inside city or town limits? yes no 15. NAME OF DECEDENT'S FATHER 17. RACE OF DECEDENT hours minutes Out Pat. Emer Rm Inpatient 5. DATE OF (mo) BIRTH (day) (year) male.

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