| Name | Daniel Edward Provost |
|---|---|
| Sex | male |
| Birth Date | June 12, 1919 |
| Death Date | October 13, 1997 |
| Age at Death | 78 years, 4 months, 1 day old |
| Birth Place | New York |
| Death Place | Riverside County, California |
| Mother's Maiden Name | Maguin |
| Social Security Number | 121-07-7268 |
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