Passport ID:                    

Court/Consulate Location:       
Passport Type:                  
Application Number:             
Oath Date:                      

Child Number:                   



Name:                           
Immigrant ID:                   BLKA-03APR1920-2-UC4-0006 

Age:                             years 
Birth Date:                     
Birth Place:                    

Occupation:                     
Height:                         
Eye Color / Hair Color:          / 



Other Relationship:             

Name:                           
Immigrant ID:                   

Occupation:                     

Comments:

Applicant/Parent:

Action	Name	Birth Date	Birth Place	Comments
	Dasho [Dashoian], Barsam K.	1862-05-20	Harput, Mamuretulaziz, Turkey	bearer of passport 302 issued 21-Nov-1916 at Constantinople