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
s // County of
ite Board of Health
„r /Zsoj / /f/KAVtit/t . 1!
r
el
State of Mississippi
/*> <■ jy ff/ijz&l
Born In
Vatins' Precinct
i
or Village. pr City.
(Hospital)
Date of Bi
FuU Name of
Sex
Full Maine of Father
Mother’s FUJI ^. Malden NinaH'.fUji
fuu f. o:
Address	A,
Registrar's Register N6..
Bom Alive?
Name and of Atl
Date Certif. Filed ate mailed to
H(frCTA^'t
-yt<f
ite Department or Co. S. Officer-
i«fL
i
19—
Registrar.
Address-
Registrfcr’a Register No.
B*m “	A
Votifc* Frecliict________
or Village _____ of City (Hospjtal)__________
*~p i
date ot Birth
Pk*e Certif. FUed,
©kte. mailed to ^7
i*£Z
.uffr
Regiifcrar_
Address-