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Registrant ID: Country: Registration Date (Conflict): Registration Location: Serial Number: Registrant Name: Immigrant ID: 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: FLRD-20DEC1909-3-8-0017 OSC2-21DEC1916-3-15-0021 Comments: residence: Walter Ave. & Fresno St. / mole above of left eye