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State Board of Health I -fzf c? 3. County, of State of Mississippi ZY/s y7/y/.^i^ ' A ^ Or Bom In Voting Preclnc or Village or City (Hospital) _ /2r Registrar’s Register No.. He Date of Birth :___sU-______-19 JLJ__________ajm._Z_ Pull Name C> <y £ J y € Of Chllri (0tCc*~X^ sC. ^ fyftzsy._____SJ.______-19.&J Q 6'a A.M. 7 P.M. _ Color. .Illegitimate? of1 Father 7 a-tASX-#sCt7-U7 Mother' Full P. C Address Born Alive? Name and Addr of Attendant Date Certif. Piled (By JTg?‘ or Stillborn?. Date mailed to State Department or Co. H. Officer Registrar Address Registrar’s Register No.________J ^ 1 Boro In Voting Precinct a^<^: <^7", or Village________________________ (Hospital) Date of Birth or City Jl -J&l IkzL lrth_^________£ 7 19^5 ____AJI., jhjPautaf 1(xJ/jL-Zy Color. .yr . Legitimate Sex. Full Name of Father. Mother’s Full Maiden Name Pull P. Address S_^ Bom Alive ?_ Name and Addri of Attendant .or Stillborn?. Date Certif. Filed. Date mailed to State Department or Co. H. Officer. J- ^r~ 19- Registrar. Address
Birth Records BSL Midwife Record-of-Birth-Hancock-County-1935-1947-(60)