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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: CROM-18AUG1890-3--0779 Birth Place: Occupation: Mother's Name: Immigrant ID: LCHM-29AUG1897-0-J-0020 Birth Place: Occupation: No. of Children Born: No. of Children Now Living: Parents' Marriage Date: Parents' Marriage Place: Comments: filed in Book D, p. 494