31 Martin Paul Tonsing Birth A
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STATE OF KANSAS. 2 0 3 1 3 1 0
PLAGE OF BIRTH.
County of .ycw^.O?*...
STATE BOARD OF HEALTH—DIVISION OF Vrr.u, STATISTICS.
Township of.
STANDARD CERTIFICATE OF BIRTH. .ci.LttLCJ*
City of VAAM>JJfc.£*x Nc^lcS".. Full Name of C h i 1 d . . ^ Z ^ L ^ L i * ^ . . . . Sex Of child,
It rMJd i« not rat M n n l , mafca R-ipplainania.] raport. ma dtractad.
Number in order of birth.
Twin. triplet, or other?
^ r?,,
Legitimate,
"—7~I
•"
rFull un
T f^-T ; F A AJJ3JJD..
^7
Residence. Color.
Ace at last // *7 birthday..ZT..:
Birthplace.
.
. _Jl2 (Month')
".'..."ST.. (Vaarn.)
Birthplace. CLLC*~>~<^. Occupation.
Occupations^
fjTfsshn.
2
NumS*r of rhlWran horn to thia mother, fnrludlnc praaaru Mrth.
^C-SJ
U;
W•^~c~-.
W
KUTTIIMJT of "hlMrfn. of thU mother BOW IWine.
C E R T I F I C A T E OF ATTENDING PHYSICIAN OR MIDWIFE.* I hereby certify that I attended the birth of this child, who was on the date above stated. • V.'h*n th<*r«r * M no ftCtmtfiaf phy*i«-ian or mMw-i!V. *hrn th* '»th*r, homMholraar, Btc. nhouia makf thU return. A •tUIborn child is onr that neither brewtWi nor •s©'** other mw{denre of Iif* fttMT birth.
u
191...
M- rt'
f Bora «.'..•-- o
(Signature) ...
'"tPhyilaUn or t&tCS&OZS
Given name addod from su, plemental report ...
(Voai)
# / '?.
birthday
> ( A^&
UA^JB
f i * j [
191J1. (Day)
Ajre a t last
Color.
(Tear..)
^
birth MOTHER. MVLUEtli.
_ _
Maid N'am< Residence.
Nam<
j Date of
(U ft>5
(To ba arnwarad on\y tn arant of plqral bireha.j
Full
street. Reg. ~So...S...^l..L
Address Filed..
LT.^vn?
_Z__
>3f M.,
NOV - 7 1996 KOI UAUD IF COPitU tHiSIS A COW Of TMF OBlSiMAL aesnFKSlUB dWTIFlEO IMIS ll»Ti • • T O P f M
fficc • VITAL
JTATISTIGS STATIST!
" -"n-
K*N3*S.
^*«-*, CTAtc
ffiOtsTfun
OF HEALTH AKO ENVIHO\'*
PLAGE OF BIRTH.
County of .ycw^.O?*...
STATE BOARD OF HEALTH—DIVISION OF Vrr.u, STATISTICS.
Township of.
STANDARD CERTIFICATE OF BIRTH. .ci.LttLCJ*
City of VAAM>JJfc.£*x Nc^lcS".. Full Name of C h i 1 d . . ^ Z ^ L ^ L i * ^ . . . . Sex Of child,
It rMJd i« not rat M n n l , mafca R-ipplainania.] raport. ma dtractad.
Number in order of birth.
Twin. triplet, or other?
^ r?,,
Legitimate,
"—7~I
•"
rFull un
T f^-T ; F A AJJ3JJD..
^7
Residence. Color.
Ace at last // *7 birthday..ZT..:
Birthplace.
.
. _Jl2 (Month')
".'..."ST.. (Vaarn.)
Birthplace. CLLC*~>~<^. Occupation.
Occupations^
fjTfsshn.
2
NumS*r of rhlWran horn to thia mother, fnrludlnc praaaru Mrth.
^C-SJ
U;
W•^~c~-.
W
KUTTIIMJT of "hlMrfn. of thU mother BOW IWine.
C E R T I F I C A T E OF ATTENDING PHYSICIAN OR MIDWIFE.* I hereby certify that I attended the birth of this child, who was on the date above stated. • V.'h*n th<*r«r * M no ftCtmtfiaf phy*i«-ian or mMw-i!V. *hrn th* '»th*r, homMholraar, Btc. nhouia makf thU return. A •tUIborn child is onr that neither brewtWi nor •s©'** other mw{denre of Iif* fttMT birth.
u
191...
M- rt'
f Bora «.'..•-- o
(Signature) ...
'"tPhyilaUn or t&tCS&OZS
Given name addod from su, plemental report ...
(Voai)
# / '?.
birthday
> ( A^&
UA^JB
f i * j [
191J1. (Day)
Ajre a t last
Color.
(Tear..)
^
birth MOTHER. MVLUEtli.
_ _
Maid N'am< Residence.
Nam<
j Date of
(U ft>5
(To ba arnwarad on\y tn arant of plqral bireha.j
Full
street. Reg. ~So...S...^l..L
Address Filed..
LT.^vn?
_Z__
>3f M.,
NOV - 7 1996 KOI UAUD IF COPitU tHiSIS A COW Of TMF OBlSiMAL aesnFKSlUB dWTIFlEO IMIS ll»Ti • • T O P f M
fficc • VITAL
JTATISTIGS STATIST!
" -"n-
K*N3*S.
^*«-*, CTAtc
ffiOtsTfun
OF HEALTH AKO ENVIHO\'*
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