| Name | John Smith |
|---|---|
| Sex | male |
| Birth Date | October 17, 1896 |
| Death Date | December 16, 1963 |
| Age at Death | 67 years, 1 month, 29 days old |
| Birth Place | Kentucky |
| Death Place | Mendocino County, California |
| Social Security Number | 000-00-000 |
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