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II i <br /> For the Year 19 <br /> OCCUPATION OF <br /> FULL NAME OF FATHER MAIDEN NAME OF MOTHER FATHER BIRTHPLACE OF BIRTHPLACE OF I DATE O: <br /> OCCUPATION OF FATHER MOTHER I RECORD <br /> MOTHER <br /> u F <br /> s <br /> t <br /> _ t <br /> v S <br /> Y�±\51d <br /> - y <br /> i <br /> V <br /> - i <br /> E <br /> i <br /> �t <br /> li <br />