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Registrant ID: Country: Registration Date (Conflict): Registration Location: Serial Number: Registrant Name: Immigrant ID: OLMP-02JUL1913-3-C36-0016 Age: years Birth Date: Home Address: Birth Place: Occupation / Employer: / Citizenship Status (Country): Height / Build: / Eye Color / Hair Color: / Nearest Relative Name: Nearest Relative Address: Nearest Relative Immigrant ID: LLRN-06JUN1908-3-10-0005 Comments: not able to work (ulcerated stomach & rheumatism), burn on left leg from knee to ankle