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. I ` <br /> DATE OF COLOR CONDITIO\T. <br /> NAME OF THE CHILD. SEX. (other (As Twin,or PLACE OF BIRTH. NAMES OF PARENTS.- <br /> °' - (If it have any.) than Illegitimate.) <br /> BIRTH. white.) <br /> 1- <br /> �'/� i��� � UJdy-zz��G�-rte- �✓��//���-�����'';�,��<�/ <br /> !fes/ i �'/ ��b"Z �✓Ytit liJ C �G �r��/ !�d�w�� ���3 <br /> R �� �2 ✓' i 7�f t C tit 0 ` �1 � J / / �J t� J�eta�w� <br /> O <br /> wR <br /> - 44 <br /> n � <br /> fir % dG2� �Ll /0 A101-le- <br /> ' ' <br /> 1,10 9, 114 U/1-60 � f �22 pel , <br /> �' <br /> - I: . ��(ry.., �� /'�_ G 1L<_; f f��C�t/t�t�..� �l�//t,�,/i,ln_=7 <br /> �lt� <br /> l� <br /> iso <br /> y �� <br /> If ' <br /> (m) 31ale; {F) Female. - -- <br /> t (B) Black; (14) 13ulatt0; (In(j.) :udiun. <br /> , ,': _ <br /> �i� <br />