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Birth ID: Certificate Location: Certificate Number: Birth Location: Birth Date: Name: Immigrant ID: Sex: Parents' Home Address: Father's Name: Immigrant ID: LCHM-11JAN1897-3--0055 ROTT-28JAN1920-2-U63-0003 Birth Place: Occupation: Mother's Name: Immigrant ID: LGSC-05DEC1898-0-S-0004 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: filed in Book 6, p. 374