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

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FAMILY WORKSHEET
1 husband's Name: jU rs in L Fp rt	>1	&__________________________ Family Number:
___________MO DAY^~YR	_________^ Place ____________ ______________Comments SOURCE:
~n?rn	(	C.	fidd
lurried ) Q - /	_________*_/___________-	_________________________
_________________v M	#?*/#	* c	Aix________________
]?laces of rpqHpnrp- /*} P-V 0 Ll__C7 _cf I/.,--------P'} ^C' /t____________________^ & ?
Occupation:?----------------------------------------------------------------^-  Religion^.- -T~7~\-7^=?1? ?
Mother L-&	A fbl/rtZ. ^___Father	j 1 (K2^i k . fr /> nJJUh <
Wife's Maiden Name: L-6$rtf\?L) tr'ne &r<LZ;	/	/-rTY^-rfidft
MO DAY YR	Place	Comments
Horn
Married [
Died
)^Tl
Places of residence:.
37" ^
L>r HJse only one source
Occupation:-------------------------------------------ReL?gioru__.--------------------------------------ff\C 156 onty one 50
Mother^	JcS<W	C'fH-CA	/*A! per family worksheet.
Children's full names		MO DAY YR	Place Other data
- \A c ^rre ?7Cole LfrfZn-f/H//	Bom	/ / ' L - itrv?	
	^Married	1 ~ 18'C'ir	hhn-\ea:.k Cc,
Spouse: ,	? /\ is. lUfe-ne / ft	Died		
			
J	Bom		
	Married		
Spouse:	Died		
			
	Born		
-	Married		
S pouse:	Died		
			
	Bom		
A	Married		
S.pouse:	Died		
			
Bom
t.	Married
Spouse:	Died
Bom
^ _______________________________________________	Married
Spouse:	Died
7. _______
Spouse:
Bom
Married
Died