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Form 3511 Nami Constantin 1360309 Romanoucka 9 Age 29 years Declaration, ofinition. No 1464. issued by Distuit Couri of Walubuy onlthe 3 day of may 19193 Serition, 10% VIII No 1821 Intersignator the 15 day of march 019190 Name age and pluce of residence of wife: amlia 22 yrs. 107 Jane St. Coatubun, Come Names ayes and piture effordence of minor children: none. Kanstantin Ramanoushas /Signature of holder./ Old certificate. Na Cer tificate No. Date may , 1920 Ki Ramonourna

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Type
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Document identity
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    "ocrText": "Form 3511\nNami\nConstantin 1360309 Romanoucka 9\nAge 29\nyears\nDeclaration, ofinition. No 1464.\nissued by Distuit\nCouri of Walubuy\nonlthe\n3 day of may 19193\nSerition, 10% VIII No 1821\nIntersignator the 15 day of\nmarch 019190\nName age and pluce of residence of wife:\namlia 22 yrs.\n107 Jane St. Coatubun, Come\nNames ayes and piture effordence of minor\nchildren: none.\nKanstantin Ramanoushas\n/Signature of holder./\nOld certificate. Na\nCer tificate No.\nDate\nmay ,\n1920\nKi Ramonourna"
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