Census ID:                          

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Census Place:                       
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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
	Tashjian, Simon	head	31	M	Harput, Mamuretulaziz, Turkey	1906	alien		CANA-12MAY1906-2-1-0018
	Tashjian, Lydia	wife	30	F	Samsun, Trebizond, Turkey	1910	alien		LPRV-11JUN1910-3-18-0015
	Tashjian, Levon	son	7	M	CA, USA
	Tashjian, Charlotte	daughter	3-9m	F	CA, USA