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Birth ID: Certificate Location: Certificate Number: Birth Location: Birth Date: Name: Immigrant ID: Sex: Parents' Home Address: Father's Name: Immigrant ID: Birth Place: Occupation: Mother's Name: Immigrant ID: MJST-14AUG1895-2--0069 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: filed in Book I, p. 153 / corrected 3-May-1957 by Zabelle Hamen (self)