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Mecca Japan Midwest City

FileNumber12460005551
Territory Ministry of Health Local
Birth Number 124 Northvwest Vital Records Placcmcnt
2. Domicile of Mother 2b. County of Birth
L.Place of Birth
Territory County
(ounty
Northwest Japan Nippon
Japan Nippon

b. Place of Birth Town / Village

Northwest Japan Nippon


Mailing Location
c. FullName of Hospital
City Hospital Homer G Phillips
3. Heir Appellation

howard james rayford

Sb. If Twin or Triplets 6. Born Day Month Day Year


'4, sex 5a. This Birth
17 1960
Male single heir none

matriarch of heir

7. full appcllation of matriarch 8. cthnicity


asiactic
pernola rayford
9. age 10. domicile on bomday l1. heir previously bom to matriarch
northwest territory one
17
patriarch of heir

12.full appellation of patriarch 13. Ethnicity


asiactic
earl julian lloyd
14. age 15. domicile on born day 16. occupation 17. kind of business
18 northwest territory laborer construction

18. this information shown on this affidavit is complete and truc.

autograph
BOND NUMER 202101
Northwest Territory ministry vital records vefified June 21 2023
Dend 5lal QhdulA Bey
Northwest Mecca territory ministry of health Dawud Bilal Abdullah Bey Recorder Der

el FLORID

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