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Death Certificate

This is to certify that the records in my office show that

Name. Johana Elizabeth Chay Juarez

Age: 12

Cause of Death: Brain tumor

Place of death: In their home

Date last seen by doctor August 09 2021

Died at 12:30 pm on August 11, 2021

Gender: FEMALE

Occupation: Student Marital

Status: Single

Please tick one of the following:

There will/ will not be hey post-mortem

The death will be reported to a coroner

[Authority]

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