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It has not been edited and may therefore contain several errors.
gjWi Bi^' 3Bteawj jrf Jttrfea fit*. " -\ ;-’' ,s£^ • sSrfBSawir ’a^ii* State Board of "Health j ^ Hxio H-srtM —--------------------------------- - State pf Mississippi Bora In Voting Preclnflt Ri^glltrar’s Register No.. /74 or Village. pr 0ity. (Hosfcitai). r Bc^n Jn voting 1 ot Vl)Uge. ot Otyy_ (HospiUl)____ plte pf pirtM JJeX. Color lAyiifohtoT ^Fattier PMe of Birth. Full Name 'of CH11<C_ Bex. 2&^feiSNtoA ^T^nSlA OL ^riAy*^!^ Full £. O. AddrBss Boh) Alive?. Natae add Address of pull Name pf Father_________ Mothbr’S PuU Malden Name. Full k O. AddregS __________ Bpm Alive?_______ STfunp and Add pf Attendant- Date Certify *tyid-Date faailed to Btata Depdrtmeilt or Co. H. Qfflder- keglatrar. AddrAss_ riegUtrfcr’S Reglftte^ Np. MX 19_______ -PM. -Color- . legltinlat^?- _of StUlbom?- .19.
Birth Records BSL Midwife Record-of-Birth-Hancock-County-1935-1947-(87)