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Birth ID: Certificate Location: Certificate Number: Birth Location: Birth Date: Name: Immigrant ID: NIMR-18NOV1916-3-16-0005 Sex: Parents' Home Address: Father's Name: Immigrant ID: LPRV-17JUL1908-3-11-0019 Birth Place: Occupation: Mother's Name: Immigrant ID: LPRV-17JUL1908-3-11-0020 NIMR-18NOV1916-3-16-0002 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: filed in Book C, p. 95