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Birth ID: Certificate Location: Certificate Number: Birth Location: Birth Address: Birth Date: Name: Immigrant ID: Sex: Parents' Home Address: Father's Name: Immigrant ID: GWLD-30JUL1903-3-B-0012 POME-29MAY1909-3-C6-0031 Birth Place: Occupation: Mother's Name: Immigrant ID: POME-29MAY1909-3-C6-0032 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: