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Furm 3411
11
1883561
Age,
Name Leo eo Semeni
35 years
Declaration No. 6669
cisued by District
Count of waterbary
on the
19 day of march, 191921
Perition, Vil. X 111 No 3183
Creder. signed un, the
or day of
Sept 09913
Name, age of residence ef cuite:
Names ages and plues infresident of minor
children:
See Simene
/Signature of /
Old Yew Na
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Context sent to Scholar
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