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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: LGSC-08AUG1904-3-J-0017 Birth Place: Occupation: Mother's Name: Immigrant ID: EUGE-11JUN1910-3-45-0010 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: filed in Book F, p. 295