Birth ID:                    

Certificate Location:        
Certificate Number:          

Birth Location:              
Birth Address:               
Birth Date:                  



Name:                        
Immigrant ID:                MAUR-01FEB1923-3-UC11-0002 
Sex:                         

Parents' Home Address:       

Father's Name:               
Immigrant ID:                CALF-23OCT1896-3--0273 
Birth Place:                 
Occupation:                  



Mother's Name:               
Immigrant ID:                HAVR-30SEP1907-3-I-0008 MAUR-01FEB1923-3-UC11-0001 
Birth Place:                 
Occupation:                  

No. of Children Born:        
No. of Children Now Living:  

Parents' Marriage Date:      
Parents' Marriage Place:     


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