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Census ID: Country (Census Year): Census Place: Page Number (Enumeration Date): Line Number: Dwelling / Family Number: / Name: Immigrant ID: LSVO-14JAN1907-3-10-0012 STPA-21JUL1912-3-C1-0015 ACRO-25JUN1921-1-C3-0011 Sex: Age: years Relationship to Head of Household: Marital Status & Children: Occupation: Home Address: Birth Place: Father's Birth Place: Mother's Birth Place: Year of Immigration: Citizenship Status: Comments: