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ERTIFIED IC0P_‘_.Y~ OF AN ENTRY OIEBIRTH

swan AT i"u1é- .'E;ENERAL REGISTER (jFF§ (:13: '

ApplicationNmnbe}.:...'.,.' ....... ..' ..... 

REGISTRAHQN D1s*m"CT »

 
   

8.S.Q. B1R’I'H'jxi :hésub‘dis{rici of  

lumns:'-A ‘E1  _' V 2 ' 3A ' 4  (6 V 7 V 3.

Mwnen 3' i'fa;w,-y _-  :scx Naxhélaswdzsirxnéxnc Nz:i:ne,.§5,;x:;x

of father - .03; father

“-")*."3‘—”."*b#‘t..2:} Qfiéow

  

_'i4n‘ihe  ...............  ....... ..

 ~

. . . . . . . . . . . . - --g.......,...-..'..-.

9 V10?

 b  Signamm. description and  Signature of Name entered
' residence of informant. regiglnred. _ registrar

after regisuafion

 

J‘?   4/mézzm. /‘fair
- tum ' 7 I

ZRTIFIED to be a tlfue copy of an entry in the ‘certified copy of a Register of i.n the District above mentioned.

ven :11 the GENERAL REGXSTER OFFICE, underéthe: Seal of the said  ..................  .............. .. day of .......  ...... ..

 

............ ..19?.3..,._.. I

ksv 4598212

CA‘U'I'l0N:- it is an offence to falsify a certificate or to make or Imowingiy use a false certificate or a copy of 9. false certificate intending it to be
amcplad my genuine to the prejudice of any person ur co possess I certificate knowing it to be false without lawful authority.

WARNING: THIS CERTIFICATE IS NOT EVIDENCE OF THE IDEN'l"ITY OF THE PERSON PRESENTING IT.

Dd0034 lO0M~ 12197 Mcr(202A'H)

‘See new overleaf