104-10180-10010.pdf

1693 201+ ' 208- 3 163226 2 33d ' 3 ' 201- OCT ee 104-10180-10010 14-00000

OCCUPATION Pvaw 4

le Yuisare terre st wet sae ore

Mn MT BIRT CITY/ RESIDENCE CITY C CITY WERTH Sauk TN sosrimero Clev BIRTH City BURMA

Teiry/ Town OF

Inser UPA Peel BA Miatnw

MAIDEN AAR AMRW aetna Nou Sa crest mae ee oe ae HAWES - GATE TRAE Givin IIE RA OHA TNS SNE mn ATEL ARONA 53d Kormions Bilin DUANAME GINEM Mam & Perret ae anata nanan tds aaennnnnemes & ° LS MOC TOWN OF BIRTH ae atten eee rr ero tant creer ne aaa DATS OF BIRTH | COUNTRY OF BIRTH cent BURMAME UMMA entra etter et ett et re SRCRET coe aneene ae patna maemo Ft eee te nnn CS Cun TINUED SL pf rr | | PALLISER SIRTH mombee ces ote COSOLETE PREVIOUS OTMER MAMES © STATS NOY ALIAG IG RETR BSB ninee tes nat AIP Ste PARMA mn ates inne + eee cae peer eee ent ec ne oe ok ae RR TTL aro ar orn teenie an ne ee Y aneaeeel teeta

MAME MIODLE ce mane wa ee ee a ee en SVEN { Re MrOW Ue Leer Pree Ree Ferman jammy ntnteahenn 2 ann MA Me samara siememmeemrraetrsiaannn ee eR ae emer eRe FEE oe nena GIVEN eos Tio Precreeremmcceey mcrae + yan eae ees meen MA Oe Mer APL MAIDEN MIOULE SutNaw se BATE Soe serteee Miter Sid fOrTIONS eteetaeiieini tite ti eet ete a mee ve nme corey PIOCLE NAS Pare Me Qe ABE Ft SPRATT ed F ETRE A CHY ue enti mete sega Fone BERT Att ASAE PYPR Se CREAT ' LOZ SURNAME GIMED BECKET remnee ee homme Givrls pai iaenialie Set ne ee vo ~f Coe TED seme ron Yeon neta tyre ce tere ee Ptemattnaete

surname town birth assign mame middle insert residence given indexing instructions sex fone number secre