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“IS IS A PERMANENT RECORD. sents Mont Ba inom. Sen tact of MARGIN RESERVED FOR BINDING \WOITR PLAINLY, WITH UNFADING certiteate, Most Be Carefully Supplied. Esa STATE OF DELAWARE JN 111885 STANDARD CERTIFICATE OF BIRTH~ 3638 AITAL STM ie iit fy: State File No. .. 49. 39 Registered No, L/D = 2 5 ee te we Ped EERE EY ES re rae e ha aa ro norm 10, Residence (usu peta) test Ay th 19, Residence (areal o sieht S © rte farpn tangy OO > 24 Tae ddl” bes Weare eT 18 Bibolace (cy o acd) Act a 22, Bintlace (ty or ot peters aoe te bigs = eee 28, Dare gent and yn 7 frases 26 Total une ea i 17. Total Tine (gear) eats ticle iciuding “ta 0) Born ave but now ded (Sabon Peco Sates ns ab sgl Ue in Byes Pee mae Cs Reg dD CERTIFICATE OF ATTENDING PHYSICIAN OR MIDWIEE = hereby certify that I attended the bith ofthis child, who was... 2B Ae dacs sigpaeeas ay Za eee Addeese, Sete cee