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Registrant ID: Country: Registration Date (Conflict): Registration Location: Serial Number: Registrant Name: Immigrant ID: MJST-12JAN1905-2-B-0017 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: OBDM-06JUL1897-0-A-0013 Comments: residence: South Ave. & Temperance Ave. / birthmark on right side of abdomen, slightly deaf