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State Board of Health 7 s
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County of
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State of Missi3sippi
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Born In
Voting Precinct
Registrar’s Register No______________'(f'Q
or Village
or
(Hospital).
City	of .
Date of BirthS’ 19HA _
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FuU Name of ChUd
Sex frX^lsU..<
FuU Name < of Fathep
Mother’s FuU Maiden Nan
Legitimate?
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Address
Born AUve?
Name and Adi of Attend!
Date Certif. FUed
Date maUed to State Department or Co. H. Officer
Registrar
Address
Born In
Voting Precinc
Registrar’s Register No.
Date of Birtl
si.
Sex	Cnlnr	or	_	Legitimate
....	.	_	..	s,.//	I	SU
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Mother’s FuU Maiden Name
FuU P. O Address.
Bom AUve?.
Name and Addri of Attendant
Date Certif. FUed
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Date mailed to State Department or Co. H. Officer
Registrar.
Address	t^a.


Birth Records BSL Midwife Record-of-Birth-Hancock-County-1935-1947-(42)
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