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t CONDITION.) <br /> CHILD. SET, ( NAME$ OF PARENTS.. <br /> DATE OF COLOR (AsTwill,0y, <br /> NAME. OF THE other (I PLACE OF BIRTH. <br /> f <br /> No. (If it have any. than 111c�itimalrJ <br /> BIRTH. (If <br /> 1 � 5 <br /> I <br /> I <br /> I <br /> i <br /> I <br /> [ I <br /> i <br /> I <br /> i <br /> t <br /> I �.y <br /> I <br /> Ee k <br /> I r' <br /> c <br /> Nm <br /> I y I <br /> i <br /> �` * (M) Male; (F) Fem11e. t (B) Black; (11) Mulatto; (Ind.) Indian. - <br />