hw Se i (To be wconanad Gulia) r te oe Pg y OFRGE OF THE OMI. RE CERTIFICATE OF ‘BRT i se SSRI ts sorta peer" are 2"Sa"e oy Fone EM Taga ices gee | gor 7, NAME (was) tt eam, mmr namo a opt tan 2 Sex Js DATE OF BIRTH Gay mart) bow 1 tae Ro rte ‘2 bor. 205 aera IC [ a. PLACE OF purectHeepta/Cink/naitaan/ jonny) (enn) Roem H] BIRTH HevarNo, hee aarp) ' uevon MSGGAL Coen, LICHLA CET a | 1b | 5 YPE OF SIRT 'B IF MULTIPLE BIRTH, CHILD WAS 3: EET sgn a te and Se" gate Ts oven sty 2 TE BATHOROER ve bee sna(eui date] oo WEIGHT AT BIRTHT Theludeg minder __ Pat _ yn tennd taste) SMADEN pmo aa) a prey 7, OMZENSHP & RELIGION mi Pe. Tosinaronal Beecher pone Wena 70> OCCUPATION Tester 12, RESIDENCE Gioce Noy Sree Bxesesy) (GMa ‘one BOMM 97.4 MARKET VIEW SUD. wom, oer 15 NAME ra wa i} J08E LE auras, un oo 14 GTIZENSHP 1S FEGON ap 0 1, OCCUPATION 7 Yonder 7B) DATE AND PLAGE OF MARRIAGE OF PARENTS fret maria asconpiah Ato = etree’ /Adeason Puen athe) MOF RATED —— a ” ‘ea ATTENDANT i yaa | CSE (alate — Matar — | RECEIVED AT THE OFFICE OF a raepaeD BY nT SRS THe OWL REG ee Ul) oon z rae ae 06646-C5-132JAS-00122-BI001 BReN haa Brae h. Pervraly ean O5E24 BOSKNOSS LISA GRACE S. BERSALES, PhD. a National Statistician and Civil Registrar Gener 1 TN nso ie HUA REM OMANfa. DATE OF BIRTH ayy toni) bea 22 Hove “PLAGE OF BIRTH i, TYPE OF BIRTH MULTIPLE BIRTH, CHILD WAS 1 Sool 20h Yat 2 cond 3 oni BIRTH ORDER (ive bane ang feral donne WEIGHT AT BIRTH 2nd dinate delivery) 3,100" ae ns, acondy irdeto) & MAIDEN rie) (waa us) aL oe 1, PREPARED 8Y Re Sia Name in Print ons via | 7 aren REGI Lie | ow ate