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Registrant ID: Country: Registration Date (Conflict): Registration Location: Serial Number: Registrant Name: Immigrant ID: Age: years Birth Date: Home Address: Birth Place: Occupation / Employer: / Citizenship Status (Country): Height / Build: / Eye Color / Hair Color: / Nearest Relative Name: Nearest Relative Address: Nearest Relative Immigrant ID: GULD-10SEP1921-3-N5-0007 Comments: scar on left jaw 1 in. from corner of mouth / residence: Peach [Ave.] near South [Ave.]