Book #

Child's last name

Child's first name

Child's middle name

Mother's last name

Mother's First name

Date Registered

Birth Month

Certificate #

Birth Day

Birth Year

121

QINSLEY

WILLIAM

-

OWENS

HARRIET

-

06

60337

20

1923

055

QUALLS

JAMES

Y

GREGORY

ANNA

-

04

27310

22

1923