Census ID:                          

Country (Census Year):              
Census Place:                       
Page Number (Enumeration Date):     
Line Number:                        
Dwelling / Family Number:            / 

Name:                               
Immigrant ID:                       
Sex:                                
Age:                                 years  months

Relationship to Head of Household:  
Marital Status & Children:          
Occupation:                         
Home Address:                       
Birth Place:                        
Father's Birth Place:               
Mother's Birth Place:               
Year of Immigration:                
Citizenship Status:                 

Comments:
                                    

Census household:

Actions:
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Action	Name	Relationship	Age	Sex	Birth Place	Year of Immigration	Citizenship Status	Comments	Immigrant ID
	Mocossian [Mokossian], Garabidt	head	38	M	Turkey	1905	papers		LGSC-30OCT1905-3-21-0014
	Mocossian [Mokossian], Mary	wife	23	F	Turkey	1905			LGSC-30OCT1905-3-21-0015
	Mocossian [Mokossian], Yevkin	daughter	7	F	Turkey	1905			LGSC-30OCT1905-3-21-0016
	Mocossian [Mokossian], Armenoohi	daughter	5	F	Turkey	1905			LGSC-30OCT1905-3-21-0017
	Mocossian [Mokossian], Satinig	daughter	3	F	CA, USA
	Mocossian [Mokossian], Archoloos	daughter	9m	F	CA, USA
	Housepian [Hovsepian], Alexander	roomer	28	M	Turkey	1904	papers
	Hamparzoomian [Hampartsoumian], Setrag	roomer	45	M	Turkey	1908			HUDS-21OCT1905-3-11-0029 ?