Natalia Snopczynska: Death certificate

1. Surname: Snopczynska
2. First name (names): Natalia
3. Surname at birth: Snopczynska
4. Civil status: unmarried
5. Date of birth: July 27, 1898 (the proper date from her birth certificate is July 27, 1888)
6. Place of birth: Warszawa (Warsaw)
7. Place of residence: Warszawa, ul. Solec 36A
II. Data concerning the date and place of death
1. Date of death: November 23, 1978
2. Time of death: -
3. Place of death: Warszawa (Warsaw)
4. Date of finding the corpse: -
5. Time of finding the corpse: -
6. Place of finding the corpse: -

III. Data concerning the spouse of the deceased

1. Surname and first name (names): -
2. Surname at birth: -

IV. Data concerning the parents of the deceased

1. First name (names)

Father: Edward
Mother: Teofila

2. Surname at birth

Father: Snopczynski
Mother: Burkiewicz

V. Data concerning the person (or establishment) reporting death

1. Surname and first name (name of the establishment): Soldan Wladyslaw
2. Residence (or address of the establishment): Szczecin, ul. Drewniana 4

VI. Comments: -

Signature of the reporting person
(-) W. Soldan
USC Director
Deputy Director Wieslaw Naumoski M.Sc.
Additional Remarks: -

Place for stamp duty: Stamp duty of 25 zlotys was received
The conformity of the above copy is certified with the contents of death record
USC Director
Deputy USC Director
(-) Krystyna Misiowiec
Round seal of the USC (Office of Vital Records) of the Capital City of Warsaw, Downtown District