This text was obtained via automated optical character recognition.
It has not been edited and may therefore contain several errors.

---

Registrar’s Record of Births County of State Board of Health A&E
.(( ncrS7.*_7.	y /	H-,i>	zEL
State of Mississippi
Born In
Voting Precinct
or Village,
Registrar’s Register No.
or City /$	3___
(Hospital).	!&__
Date of Birth 9f <n^ /&____________________19-J-5_______A.M. 7^P.M.
/lsC^<. C\
Sex L.f'-e^uuT.i
Full Name
_ Color Jjf
of Father
Mother’s /Full Q	-2"
Malden/. Name
Full P. O. Address _
Born Alive?	0
_or Stillborn?.
Name and Addresa(7, Q- /? Z7 f)	/'
of Attendant______/	^
Date Certif. Plied.
Date mailed to State Departn or Co. H. Officer
19 3 f>. ab2lJ
J£l, & £
Registrar
Address
Bom In
Voting Precinct _ or Village.
Registrar’s Register No. cy^^rc~7:.
oTl
gajU M.
(Hospital)
or City_______________
6tr
7 1° A.M. /, P.M.
Date of Birth. Qtrr- AY
Full Name()y Of Child /S	tf\	-\	■>	7	&-'	/	C-^t	-	l.
iU
Sex	____Color ^d -UZa21j»glMmn.t-.p.? V .<-
Full Name '->vf	£	'	e	P	Gi/
of Father	^C^-f
Mother’s FuU .jo;	,	"/	,.	,	/Z?/J
Color____gltimate?__________________V^O
Mother’s Full Maiden NameJ
^Maiaen Name ''Z7^r
Full P. O.	/'	/■/	'
Address ^'4 r?. /Zc_________-jfc-^V	y
Born Allve?_
_or Stlllbom?-
Name and Address-/ '? {)	-•	at	/A	<7	’
of Attendant	<S	X	tfc	g	/iy .4--<	'i-p
Date Certif. Filed.	?T	.L.__________X9JLP"
Date mailed to State Department or Co. H. Officer	-
//; ' .
RoglAtrnr Address.
V7 7