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DETAILED BIRTH INFORMATION
REGISTRATION NUMBER: 1906-004932

CHILD'S DETAILS
Last Name: ENS
Given Names: JOHN
Sex: MALEDate of Birth: 19/04/1906
PLACE OF BIRTH DETAILS
Name of Hospital:
Place of Birth: R.M. OF STANLEY
USUAL RESIDENCE OF MOTHER
Address:
City, Town, Village, Rural:
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MAILING ADDRESS OF MOTHER (IF DIFFERENT FROM RESIDENCE OF MOTHER)
Address:
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OTHER PARTICULARS
Duration of Pregnancy: wksNumber Liveborn Including This Birth: Number Stillbirths:
Birth Weight: gramsParents Married: YESMother's Marital Status: MARRIED
FATHER'S DETAILS
Last Name: Given Names:
Place of Birth: Date of Birth: Age:
MOTHER'S DETAILS
Maiden Last Name: HEPPNER Given Names: LIZZIE
Place of Birth: Date of Birth: Age:
 
Date of Registration: