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Witnesses:                   

Groom Name:                  
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Age:                          years 
Birth Date:                  
Occupation:                  
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Home Address:                
Birth Place:                 

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Immigrant ID:                
Age:                          years 
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Groom Father Name:           
Immigrant ID:                
Birth Place:                 

Groom Mother Name:           
Immigrant ID:                
Birth Place:                 

Bride Father Name:           
Immigrant ID:                LAUR-10NOV1910-3-44-0010 
Birth Place:                 

Bride Mother Name:           
Immigrant ID:                ZEEL-13DEC1920-3-C11-0022 FRAN-16JAN1921-3-14-0018 
Birth Place:                 


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