Front:
Graceimora tuericau
Name of Child,
No..
Ceonora.
Serl
Auuricau
Sex,
Race,
Tle s8tad. 1894
li3.0Pm
Bartlett
aElla qlouoa lapph
linciuiati Chio
Date of Birth,
George teusy
Name of Father,
Name of Mother before Marriage,
Nativity of Father,
Calesu
Nativity of Mother,
Elictricia
ly
Max
Belpedery hariy lo Cal
Occupation of Father,
lo Pal
Residence of Parents,
Name of Physician or Midwife,
.... ...
Back:
TED
POSTAL
GARD.
ht
د بر
NOTHING BUT THE ADDRESS TO BE ON THIS SIDE.
BOARD OF HEALTH,
New City Hall,
SAN FRANCISCO.
