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

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[To be returned to the Circuit Clerk of the County in which the Birth occurs.]
2.	Sex, ...
S.,, Color, y^^rg^...............................
Jf. State if still-bornf.........................
5. Fall name of Father,
5. Name of Mother pruuitiua 'Ivhmray:rmjfe,:
1.	Month, clay ancl year of Birth,
V* "<i.:
7.	Nativity of Father, ..............-................:.........;....
8.	Nativity of Mother, .........................................cy?..#..,.
I hereby certify that the above is a trite return of the Birth and other
facts above recorded.
Dated at /%?*.
County of	.......,Miss., ,•	^
this..
is ....jj^Ldtt^duy of.	18 7/9...
7 , ^
Residence ..c
* State whether White, Black, Mulatto, Indian or other Races.
f Strike out these words if the Return be made by some other person, and add other explanatory words.