HomeMy WebLinkAboutBURCHIK_IRMA_3925635No.3925635
Narne __BJIBJ:~__~~_
residing aL __Q?~LBJ.ID __Axe ....~_.strahane.,__P..a •_
Age __.4.2 years.Date of order of adrnission----..JanU.f1.:PY---1-3-r -lB3
Date certificate issued J~nu.ary-_L3 .,__1.9.3.6.by the
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Petition No.__27.54________/h 4i1/]':22::L~_jl)AA/)-'::(_/)_
(Complete and true signature 0 hOld~