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Registrant ID: Country: Registration Date (Conflict): Registration Location: Serial Number: Registrant Name: Immigrant ID: LPRV-26SEP1908-3-16-0019 Age: years Birth Date: Home Address: Birth Place: Occupation / Employer: / Citizenship Status (Country): Height / Build: / Eye Color / Hair Color: / Nearest Relative Name: Relationship: Nearest Relative Address: Nearest Relative Immigrant ID: Comments: burn scar about size of dime on top of right arm, about 3 in[ches] above wrist, burn scar about size of dollar on top of left arm 2.5 in[ches] above wrist.