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Birth ID: Certificate Location: Certificate Number: Birth Location: Birth Address: Birth Date: Name: Immigrant ID: Sex: Parents' Home Address: Father's Name: Immigrant ID: STAT-27JUL1902-0-A-0022 VOLT-08AUG1910-3-C3-0016 Birth Place: Occupation: Mother's Name: Immigrant ID: VOLT-08AUG1910-3-C3-0017 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: