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1 7R6

101

RECORDS OF THE OFFICE
OF THE COMPTROLLER OF
THE CURRENCY

Records of the Dion of Inc.olyent
National BanksRecords of the Freedman's Savings and
Trust Company, 1665 - 1920
LOAN AND REAL ESTATE LEDGERS
AND JOURNALS, 1870 — 1916

VOL. 08 of

1 °




PC-45
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HEALTrl DEPARTMENT,
DISTRICT OF COLUMBIA,
No. 212

Street Northwest,
WASHINGTON, DC.

Transcript of Death,




1.1

Form No. 7..1

410,

DEPART

•

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413
DISTRICT OF COLUMBIA,
No. 212 41 Street N. W.

,

Ofrad4

I.

A TRANSCRIPT from the RECORD OF. DEATHS in the District of Columbia.
NAME OF DECEASED.

PATE OF DEATH

AGE OF DECEASED.

CONDITION.

BIRTHPLACE.

1

HOW LONG RESIDENT IN DISTRICT OF COLUMBIA.

•
PLACE OF DEATH.

CAUSE OF DEATH.

DURATION OF LAST SICKNESS.

1zC

71

ds:4-.2.s
A.ext

_ St.

UNDERTAKER.

MEDICAL ATTENDANT.

PLACE OF BURIAL.




No. 4/02) •C

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HEALTH DEPARTMENT,

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DISTRICT OF COLUMBIA,

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No. 212 4-i Street Northwest,

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FORM No. 7,

1,111 D EPA R2
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DISTRICT OF CO
LUMBIA,
No. 212 44 Street N. W.

`aanwubis

`saals!s pue aatiwag

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JEL
A TRANSCRIPT from the RE
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District of Columbia.
NAME OF DECEASED.

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AGE OF DECEASED.

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CONDITION.
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IN DISTR icr IF coLumitiA.

ell ctn./LA.1A.
DURATION OF LAST SICKNESS

CAUSE OF DEATH.

2.0"A.A4t1

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UN 1)E.R1 AK ER

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health.Offieer and Registrar.

Chief Clerk.
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`uoixaiduv

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EDICA I, ATTENDANT

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PLACE OF BURIAL

PLACE OF DEATH.

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FORM NO. 7.

D EPA

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DISTRICT OF COLUMBIA,
No. 212 4A Street N.W.

01;zdZw
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A TRANSCRIPT from the RECORD OF DEATHS in the District of Columbia.
NAME

..........

DATE

DECEASED.

OF

...

DEATH.

....

AGE

OF

DECEASED.

4.f`

7.
/fg-

LONG RESIDENT IN DISTRICT OF COLUMBIA.•

HOW

BIRTHPLACE.

CONDITION.

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OF

a4•

DURATION

OF

CAUSE

LAST SICKNESS.

OF

.......

PLACE




OF

BURIAL.

PLACE

DEATH.

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OF

DEATH.

Jiro. ee"/

MEDICAL ATTENDANT.

St

UNDERTAKER.

cSiXeee g
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Health

M P.
cer and Registrar.

ATTEST:

Chief Clerk.




HEALTH DEPARTMENT,
DISTRICT OF COLUMBIA,
No. 212 41 Street Northwest,
WASHINGTON, DC.

Transcript of Death.

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[FORM

No. 7.

D EPAR2

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DISTRICT OF COL
UMBIA,
No./

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No. 212 41 Street N. W.

Date,

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A TRANSCRIPT from
the RECORD OF DEATHS
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NAME OF DECEASED.

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DATE OF DEATH.

AGE OF DECEASED.

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PLACE 1W DEATH.

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PLACE OF BURIAL.

MEDICAL ATTENDANT.

UNDERTAKER

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HEALTH DEPARTMENT,

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DISTRICT OF COLUMBIA,
No. 212 44 Street Northwest,
WASHINGTON, D. C.

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OF COLUMBIA,

RECOF
No. 212 41 Street N. W.
Date,
Where born,
9traL

5

4

Where brought up,

A TRANSCRIPT from the RECORD OF DEATHS in the District of Columbia.

Residence,
Age,

NAME OF DECEASED

DATE OF DEATH.

AGE UI I )I

I \-,1 I)

Occupation,
Works for

7
-z-G4

Wife or Husband,

HOW LONG RESIDEN'I
TRICT OF COLUMBIA.

BIRTHPLACE

Children,

Father,
DURATION OF LAST SICKNESS

,
PLACE ( )1 DEATIl.

CAUSE OF DEATH

Mother,

e

Brothers and Sisters,

t(..14

PLACE OF BURIAL.

No.
UNDERT A KI I.

MEDICAL ATTENDANT.

REMARKS:




-4 1.
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dp1

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^

t.
Health 0j91rer and Registrar.

Signature

ATTEST:

Chic
uslousios.m.

NJ

No4/_/

Date,

Date,

Where born,

Where born,

Where brought up

Where brought up,

t 24/ ty
RECORD of
(
-

14

Residence,

;7

Age,

,

RECORD for 77

Residence,
Age,

Complexion,

Complexion,
X

Occupation,

Occupation,

Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,

Brothers and Sisters,

Brothers and Sisters,

REMARKS:

REMARKS:

t.,

Signature,

Signature,

RECORD for

(

•

4

N1(

ECORD for

Date,

Date,

Where born,

Where born,

Where brought up,

Where brought up,

Residence,

Residence,

Age,

Complexion,

Complexion,

Age,

Occupation,

Occupation,

Works for

Works for

Wife or Husband,

Wife or Husband

Children,

Children,

Father,

Father,

Mother,

deb

Mother,

Brother and Sies•

Brothers and Sisters,

REMARKS:

REMARKS:




Signature,

Signature,

No/ /
(
2ECORD for

No/( yRECORD for ./.
2-

At.
Date,
Where born,

)7,3

A

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Date

4
4

Where born,

4
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Where brought up,

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Residence,

Residence,

Age,
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7/73

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Age,

Occupatior{,

Occupation,

Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,

Brothers and Sisters,

Xaa,

-1/2- "----6

Brothers and Sisters,

REMARKS:

REMARKS:

Signature,

Signature,

NoA

Z Complexion,
A,
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-/RECORD for`-/12

7
4
1

Date,

NodU

RECORD for

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Date,
Where born,

Where born,

Where brought ui),
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Where brought up,

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Residence,

Residence,
Complexion,

Age,

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Age,

Complexion,

Occupation,

Occupatio

Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,
Brothers and Sisters,

Brothers and Sisters,

REMARKS:

REMARKS;




Signature,

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Signature,

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No/(}1 ----RECORD of

No./61
-5 RECORD for

Date,

Date,

Where born,

Where born,

Where brought up,

Where brought up,
j

Residence,

Residence,

Age,

Age,

Complexion,

A

Occupation,

Occupation,

Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,

Brothers and Sisters,

Complexion,

Brothers and Sisters,

Y/r•

REMARKS:

//2 -

REMARKS:

Signature,

Signature,

No/ / `RECORD for
1 1:

NAV- S RECORD for

Date,

Date,

Where born,

Where born,

Where brought u p,
Residence,

Z.
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Age,

Complexion,

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Where brought up,

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Age,

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Complexion,

Occupation,

Occupation,

Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,

Brother and Sisters,

Brothers and Sisters,

REMARKS:

REMARKS:




Signature,

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Signature,

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RECORD for

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Date,

Date

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Age,

Complexion,

Age,

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Children,

Children,

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Mother,

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Brothers and Sisters,

Brothers and Sisters,

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Date,

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Date,

C

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Where brought up,

Where brought up,

Residence,

Residence,

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Complexion,

Occupation,

Occupation,

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Works for

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Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

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Brothers and Sisters,

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k_
REMARKS:

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Works for

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Children,

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Father,

Father,

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Brothers and Sisters,

Brothers and Sisters,

REMARKS:

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REMARKS:

RECORD for

Date,

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Where born,

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REMARKS:




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Date,

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Where born,

Where born, lead

Where brought up,'

Where brought up,

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Works for

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Children,

Children,

Father,

Father,

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Brothers and Sisters,

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REMARKS:

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No.

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Date, ((Ur )

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DISTRICT OF COLUMBIA.
Works fl

No. 212 41- Street Northwest,

Wife or

WASHINGTON, D. C.

Children

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Transcript of Death.
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No. -7 A2 )71i RECORD for

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No. 212 44 Street N.W.
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A TRANSCRIPT from the RECORD OF
DEATHS in the District of Columb
ia.
NAME OF DECEASED

DAL I- (

DEATH

CONDITION.

DURATION OF LAST SICKNESS

/Fg3:2.1
LI RTHPLACE.

It
HOW LONG RESIDENT
IN DISTRICT OF COLUMBIA.

CAUSE 0 bEATH.

PLACE OF DEATH

St.
MEDICAL A EN PANT.

UNDERTAKER.

ceauamsuu

`uaapimo

PLAE OF BURIAL

`saals!s puu saamloas

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AGE OF DECEASED.

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FORM

No. 7. I

DEPiU
Signaturc

DISTRICT OF COLUMBIA,
No. 212 41 Street N. W.
RECO

Date,

9frad

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A TRANSCRIPT from the RECORD OF DEATHS in the District of Columbia.
AGE OF DECEASED.

DATE OF DEATH.

NAME OF DECEASED.

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BIRTHPLACE.

CONDITION.

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PLACE' OF DEATH.

CAUSE OF DEATH.

DURATION OF LAST SICKNESS

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7

W/6-4,dc
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/i7"
-7--

Date,
Where born,

Date,
•

a- 1
5

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Where broug

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ny

up,

Residence,

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Complexion,

Age,

Age,

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Occupation,

Occupation,

Works for

Works for
Wife or Husband,

Wife or Husband,
Children,

Children,

Father,

Father,

Mother,

Mother,

Brothers and Sisters,

Brothers and Sisters,

REMARKS:




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Signature,

Signature,

6 /r).&4dol.e

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•—

No"
2

•/
/7

Date,

Iz

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&E/W

Date,

Where born,

(
I,

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,/

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/

1.444.1

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Age,

Complexion,

Age,

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Occupation,

Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,

Brothers and

Brothers and Sisters.

HEALTH DEPARTMENT,

REMARKS:

DISTRICT OF

-r 7

REMARKS:

COLUBIRIAr

No. 212 44
Street Northwest,
WASHINGTON, D. C.

Transcript of Death.

Signature,

//
No ‘ — RECORD for ,
7‘"

Date,

Date,

Where bor

Where born,

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Where brought up,

Residence,

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Age,

Age,

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No,7-- 0 6

/

Date

/

Date,

ECORD

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REMARKS:

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No.2

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REMARKS;

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1

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/

Date,

Date,

Where born,.

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)

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RECORD for ,

Date,
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/
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Foirm No

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OF COLUMBIA,

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Signature,

DISTRICT

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/77i27,

A TRANSCRIPT from the RECORD OF DEATHS in the District of
Columbia.
NAME OF DECEASED.

Za.,,p74.-

DATE OF DENI'll

AGE OF DI

V-1 I

</bi- a tr.' into
-A(

CONDITION.

BIRTHPLACE.

HOW LONG RESIDENT IN DISTRICT OF COLUMBIA.

DURATION OF LAST SICKNESS.

CAUSE OF DEATH.

PLACE OF DEATH.




No. 24Alf
PLACE OF BURIAL.

MEDICAL ATTENDANT.

UNDERTAK ER.

Health

/fifer and Registrar.

ATTEST:

Chief Clerk.
0.761 /MI IT,

NoYill/ RECORD of
/

Noo
2

Date,

Date,

-

.RECORD for

-

Where born,,

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Age,

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Age,

Complexion,

Occupation,

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Works for

Works for

Wife or Husband,

Wife or Husband,

Children,

Children,

Father,

Father,

Mother,

Mother,

Brothers and

Brothers and Sisters,

REMARKS:

HEALTH DEPARTMENT,

REMARKS:

DISTRICT OF
COLUMBIA,
No. 212

41 Street
Northwest,
WASHINGTON, D. C.

Transcript of Death,

Signature,

/

•

Date,

RECORD for

Date,

Where bor

Where born,

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Residence,

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Age,

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REMARKS:

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REMARKS:

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No. 21L

C/KLWRECO-RD for

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Wher-

/75-.

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()RECORD of 7,,

No)f‘,10 RECORD

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VVher

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REMARKS:

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REMARKS.

REMARKS:

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Date,

Date,

Where born,

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REMARKS:

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Brothers and Sisters,

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No.,9- e67

4_1 RECORD for lir:
1°

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Date

D
Date

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7
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Signature,

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Date
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FIECORD
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