Personal Information Full Name Collins, John Notable Last Name Collins First Name John Middle Name Suffix Prefix Maiden Name Time lived in city Address Occupation Blank Age at Death 43 Dates Date of Birth / / 1878 Date of Death / / 1921 Locations Hospital Birthplace Father's Birthplace Mother's Birthplace Burial Death Certificate Cause of Death Blank Undertaker Blank Plot# Inscription Family Spouse's Name Marital Status Father's Name , Mother's Name ,