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Form 390.
Nanfentificate
1175809
9
Name Samuel Thomas Patrick
Age, 33
years
Declaration ofinlance No 3130
issued by District
Court waterbary
onlhe
17 day of april AND
Perition, Yoil. 7 No 1625
Ontersignation the 5th dayal
September
Name age and place of residence of scife:
forms, 30yrs. 188 Cherry Sl.
waterbay Some.
Names ages and places infresidence ofminor
children: Louise,byrs.
188 cherry S1. Waterbery CK.
Samuel Thomas Patrich
/ Signature of holder.)
Certificate New Old certificate. Na No 1175809 Received
Date Sept 20
1919
Samuel Shomar Patrich
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Document data
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DTO data
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Context sent to Scholar
Document identity
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Page context
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"ocrText": "Form 390.\nNanfentificate\n1175809\n9\nName Samuel Thomas Patrick\nAge, 33\nyears\nDeclaration ofinlance No 3130\nissued by District\nCourt waterbary\nonlhe\n17 day of april AND\nPerition, Yoil. 7 No 1625\nOntersignation the 5th dayal\nSeptember\nName age and place of residence of scife:\nforms, 30yrs. 188 Cherry Sl.\nwaterbay Some.\nNames ages and places infresidence ofminor\nchildren: Louise,byrs.\n188 cherry S1. Waterbery CK.\nSamuel Thomas Patrich\n/ Signature of holder.)\nCertificate New Old certificate. Na No 1175809 Received\nDate Sept 20\n1919\nSamuel Shomar Patrich"
}