Birth ID:                    

Certificate Location:        
Certificate Number:          

Birth Location:              
Birth Address:               
Birth Date:                  

Name:                        
Immigrant ID:                M@WW2-U-CA-Kings-Hanford-129-3623-AsdH 
Sex:                         

Parents' Home Address:       

Father's Name:               
Immigrant ID:                LTRN-17DEC1906-3-23-0011 
Birth Place:                 
Occupation:                  

Mother's Name:               
Immigrant ID:                KONA-09JUL1908-3-2-0001 
Birth Place:                 
Occupation:                  

No. of Children Born:        
No. of Children Now Living:  

Parents' Marriage Date:      
Parents' Marriage Place:     


Comments: