CERTIFICATE OF BIRTH
City: Omaha
Street: 2507 Pierce St.
FULL NAME OF CHILD: Martin Miles Jensen
Sex: Male
Full term: Yes
Legitimate: Yes
Date of Birth: 5-11-1931
FATHER
Full Name: Lars P Jensen
Post Office: 2507 Pierce St.
Color or race: White
Age at Last Birthday: 47 years
Birthplace: Denmark
Trade, Profession: Truck Driver
MOTHER
Full Name: Ruth Edith Norby
Post Ofice: 2507 Pierce St.
Color or race: White
Age at Last Birthday: 41 years
Birthplace: Nebraska
Trade, Profession: Housewife
Number of Children of this mother (at time of this birth and including this child): 5
CERTIFICATE OF ATTENDING PHYSCIAN
I hereby certify that I attended the birth of this child, who was Born Alive at 1:30 PM
No comments:
Post a Comment