HomeMy WebLinkAboutBARAN_BARBARA_4550104No.4550104
residing aL .MY..~E?J __1?_~~_J:}?'y~-,z:q.!r!.~_
Age __~_~years.Date of order of admission __.:[9nlJ~:rJl_~_,.__19.Q.9_
Date certificate issued .J?-A ~~"f']l _~!__:l~_~~by the
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Petition No.:?~~1 _
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(Complete and true Signa~~fholder)