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Dwelling / Family Number:            / 

Name:                               
Immigrant ID:                       
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Age:                                 years 
Relationship to Head of Household:  
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Home Address:                       
Birth Place:                        
Father's Birth Place:               
Mother's Birth Place:               
Year of Immigration:                
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Comments:
                                    

Census household:

Actions:
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Action	Name	Relationship	Age	Sex	Birth Place	Year of Immigration	Citizenship Status	Comments	Immigrant ID
	Patigian, Witis	head	65	M	Turkey	1890	naturalized		RUGI-28SEP1891-3--0029
	Patigian, Lily	daughter	26	F	Turkey	1892			RUGI-28SEP1891-3--0032
	Patigian, Arthur	son	11	M	CA, USA