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Birth ID: Certificate Location: Certificate Number: Birth Location: Birth Date: Name: Immigrant ID: ROCH-10JUN1921-3-4-0021 Sex: Parents' Home Address: Father's Name: Immigrant ID: ROCH-10JUN1921-3-4-0020 Birth Place: Occupation: Mother's Name: Immigrant ID: LSVO-28JUN1920-3-12-0014 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: filed in Book D, p. 478