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J� <br /> --- DATE OFa t CONDITION. <br /> coLOR xnalEs of PARENTS. <br /> No <br /> NAME OF THE SET. <br /> CHILD. other.- (AS�I�A�'1°+O1' PLACE OF BIRTH. <br /> BIRTH. (Ifit have any.) (than Illegitimate.) <br /> 3 <br /> 0.'�-"`'�s L( <br /> r <br /> 4 A O\j <br /> rc / t7'b vr�Q U-V���XXiS' YOU <br /> rwuna I <br /> JwV. •S . ' �l 1 , sY1 "� }1/L �uW`Uv;1, ��¢ti,s <br /> i� tc 7.l'.!✓5.v� Q.L�Lt�S �r 11i"yL c c �9` U O 3 <br /> i <br /> 21 <br /> F <br /> 11, j'4/t <br /> e <br /> c w <br /> t � - <br /> iI <br /> ra; <br /> f <br /> + <br /> r• <br /> --- (a[) Male; (F) remale. --------_--- _ <br /> ._. f (B) Black; (111) Alulatto; (Incl.) Indian. <br /> � S <br /> y <br />