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G - <br /> I Form R-329. 2m-6-39-.42535! <br /> ` W tu of <br /> (USE TWO LINES WHERE NECESSARY, ALL NAMES TO BE GIVEN IN FULL.) <br /> DATE Condition, <br /> NO. OF FULL NAME OF CHILD SEX as Twins, COLOR PLACE OF BIRTH FULL NAME OF FATHER <br /> B etc. <br /> a6 � <br /> �P. �cf��ti►--�Q vs�A , Lr �� �.�,cam 1 C o�-�' <br /> r Cf2Z e,4 4. <br /> T y � - <br /> TAA: <br /> -_. <br /> oze <br /> ,t4' <br /> L 4f 1 -r. <br /> 13 <br /> i ny m <br /> } <br /> e. <br /> 1114"� r � <br /> n?I�hefyRA - _ _ =a%inav7� _J7'V1 �eo <br /> i <br /> QP/V 3-/,4 6 le— 6!ofa1 4, h� V <br /> ./7 WAY KAkyti JyNN dewli «Ief F <br /> C' <br /> f r } w >�Rti S'fi9 d'/e vr �iS �i iv c a /ai /le IVcy(C KS <br /> /if mqctN /Vllite%_ J, (,wue i4Toti ge6bee-r#eVd <br /> l3 MAKcN V/ V l A N FeA/ve .s A vA tit f n,D 1 <br /> d2-"If/L <br /> `, = IA. COUNTY �11t ( pIIT11tA'AwRSIt� Of�188flSc111lBCnB 2A CITYrtOWN MAKING RETJRN ,. .._.�. <br /> 4_ <br /> DEPARTMENT OF PUBLIC HEALTH v 2 <br /> 1/ <br /> I m Barnstable + : - REGISTRY OF VITAL RECORDS AND STATISTICS Barnstable <br /> LL 2B - <br /> PRINT h 1. IB CITY/TOWN 'i .'1 = ;3 AFFIDAVIT AND CORRECTION REGISTERED NUMBER <br /> - '' . <br /> LEGIBLY OR I w OF A RECORD OF BIRTH Barnstable 3 =&'V Q 77' <br /> TYPE WITH Q IC FACILITY NAME—IF NOT IN FACILm,NUMBER AND STREET 2C DEPOSITION NUMBER <br /> PERMANENT CL Cape Cod Hospital 12/21 X98 I �y T <br /> .. �� BLACK INK. L I NAME- 3A FIRST 313. MIDDLE X. LAST <br /> THIS ISA <br /> r / k SEX SA. PLURALITY 56 BIRTH ORDER III notrqa d1. TIME 68. DATE OF BIRTH Iwwm.Dar.vw 00 M <br /> orf PERMANENT Ma 1 e I,�,I,s.�a,.T.•,.•R) Smcey Om F,,,.Secwb.we.) n <br /> 15 RECORD. �D .e COLOR Indian --- --- 12:45P M April 8, 1963 UMC wSTi4 <br /> NAME: 7A. FIRST 7B. MIDDLE 7C LAST 7D. MAMeNfiNRTH SURNAME <br /> N Jeanette Frances Avant Junior <br /> / T BIRTHPLACE K CITYnXNVN OR STATE I COUNTRY9 OCCUPATION I0. AGE/DQE OF BIRTH <br /> - i H MA Housewife 17 <br /> E RESIDENCE- ILA NUMBER AM STREET "a Cf WTOWN IIC- COUNTY IID. STA E TIE. ZIP CODE 12. DOLOR I RACE C ale h h e h o <br /> R lo.rw _1 <br /> / f 7 mwlw�Ml Collins Lane Mashpee Barnstable MA 02649 Colored <br /> NAM: mA- FIRST 138 MIDDLE 13C. LAST U. COLOR I RACE d/ <br /> 1 T Bruce Chandler Avant Indian AfSO AJ <br /> EHI 9IRn*%ACE ISI. CITVITOWN ISS SWEICOUNTRY IS OCCUPKTION 17. AGE/OQE OF BIRTH- <br /> IRI Neal Bedford MA Laborer 23 <br /> TITLE <br /> wWkEl amm. Cl Pow-mm ❑ CERTIFIER ONLY na <br /> E ® mow ❑ CHM ❑ CITH RN ❑ MIDV0% ❑ OTHER / �1 7`► u! Q �, <br /> b NATE Sk LIIXNSE NUMBER <br /> Q F Paul B MD <br /> - F 3W NQ E STREET 208. crrwTt►YN 20C SIRE 200 Zi CODE <br /> R ---- Barnstable MA 02655 . <br /> C !t. am OF ORKIIIML RECOROPIG 22 CFNGRML RECORD n DPH USE ONLYVal paw 3 <br /> AuQust 29 1963 <br /> Pt The oboe Cc'@CI ris w" F*KW a ID tM 081er1wt on the Isllerse of ens tam hos been entered upon the birth nlerxds of tlts <br /> E Cih/Uwa of RArnetahla in eotordarloe with rie prohsiotls of General Laws.Ch.46,on <br /> December 22. 1998 end twpy an awsco0f tttis ton„ M1,010 imw of Pubic Hew,on December 22, 1998 <br /> R oft leert PMOL Der Vm" <br /> KI <br /> t+�•w-7�iClV � r • <br /> w <br /> i Crit or Regm- <br /> . <br />