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Marriage Record Location:    
Marriage Record Number:      

Marriage Location:           
Marriage Date:               
Performed by:                
Witnesses:                   

Groom Name:                  
Immigrant ID:                
Age:                          years 
Birth Date:                  
Occupation:                  
Marital Status:              
Home Address:                
Birth Place:                 

Bride Name:                  
Immigrant ID:                
Age:                          years 
Birth Date:                  
Occupation:                  
Marital Status:              
Home Address:                
Birth Place:                 

Groom Father Name:           
Immigrant ID:                
Birth Place:                 

Groom Mother Name:           
Immigrant ID:                
Birth Place:                 

Bride Father Name:           
Immigrant ID:                LSVO-01MAR1912-3-11-0009 
Birth Place:                 

Bride Mother Name:           
Immigrant ID:                
Birth Place:                 


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