Edwin Washington Project

EWP 4-4 Margaret Lee Hansbarger

Item

Title

EWP 4-4 Margaret Lee Hansbarger

Description

Birth Certificate

Tag

White Teacher, Birth Certificate

Place

Virginia

Identifier

1020818

Is Version Of

1020818_EWP_Hansbarger_Margaret_Lee_01.jpg

Is Part Of

Petitions

Date Created

1/7/24

Format

Jpeg Image

Number

08b701d0893b58748613706ee0fbebfa6b00ad7e03c90a1a7fcd1749cdfc5f6e

Source

/Volumes/T7 Shield/EWP/Elements/EWP_Files/Access Files/Upload temp/1020818_EWP_Hansbarger_Margaret_Lee_01.jpg

Publisher

Digitized by Edwin Washington Project

Rights

Loudoun County Public Schools

Language

English

Replaces

/Volumes/T7 Shield/EWP/Elements/EWP_Files/source/Ingest One/4 Faculty Staff and PTAs/4-5_Lists_and_Teacher_Cards/4-5_White_Teacher_Cards/EWP_Hansbarger_Margaret_Lee_01.jpg

extracted text

de-

formity on back of certificate and

write OVER on front.

If child is deformed describe

WRITE PLAINLY, WITH UNFADING BLACK INK (WRITING FLUID)—THIS IS A PERMANENT RECORD

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THE OTHER, No. 2, etc.,in question 5.

e ————————————————————————————— e e



.lefi M Witness to signature‘
Date rec by reg

CERTIFICATE OF BIRTH
Department of Commerce COMMONWEALTH OF VIRGINIA

Bureau of the Census DEPARTMENT OF HEALTH .
BUREAU OF VITAL STATISTICS Registered No.

—_fi_——_fi__fi——'-———__~———————_—=————-fi&%—_—" ——
. PLACE@ BIRTH , G, . USUAL RESIDENCE OF MOTHEB
/ Registration
(a) County__ District No. (a) State

For reg. use
(b) County.

(c¢) City or town

(d) Name of hospital or institution 1) X (d) Street no.

(e) Is place of residence within corporate limits? \ ;é__
o If child is not yet
. Full nare of chld_ Y QYT | S_Ed_r () € S e 40T T Tnamed;leave blank:
Boy ] L%

. or . 5. Twin or If so, born 1st, 6. Months 7. Is mot marn

Girl Triplet___~ 2nd,or3rd_______ of preg- to father
Write word of child?

FATHER OF CHILD

>

. Full name_\__J1Q 2 dCo/l) A hS NV b,

N
10. Color or rzit ln = 13 Age at time ofthis birth_y_# , /FS.
12. Birthpiace L { ] 3 e o hPoOc h U YV V9,

City,(\gwn, or county State gf fdreign country ) ‘
13. Usual occupation : : 19. Usual occupation

(e) Is place of birth within corporate limits?



_14. Industryorbusiness | 20.Industryorbusiness__________________



21.j¢hildr’en born to this mother: §
(a) How many other children of this mother are now living?_r_‘q‘-_‘_flh__é_.

. (b) How many other children were born alive hut,are nowdead?_ - __

(c) How many children were born dead?





; : = _____——%——:
23. | hereby certify that futeagedsige-bistiedf this child-wism wa@ - . t the hour of_AQ__ggdgM. on the date above'

Born aljve or sti}lbora * ‘ —
Q
y . related to this child asm



Own signature of registrar, deputy or sub.


Item sets

EWP 04 Faculty Staff and PTAs