Part 114, page 38
Document date 23 July 1942
FBI 164-81, Vault Part 114 p. 38 (DB Cooper-10660), Form, dated 23 Jul 1942 — cooper.theunsolved.net/parts/Cooper-Part-114/pages/38
Transcript
The scan is the source; the transcript is machine-generated from it.
No 717872
---
July 23, 1942
Ira P. Williams Director, Bureau of Vital [guess: Statistics]
---
COMMONWEALTH OF PENNSYLVANIA [UNITED VITAL STATISTICS] CERTIFICATE OF BIRTH
PLACE OF BIRTH [illegible borough/township], [guess: Montgomery] [guess: County] [illegible] Registration Date No. [illegible] File No. 177419 [guess: October] [illegible], [illegible]
FULL NAME OF CHILD: [guess: Sebastian] [illegible]
[Sex] [illegible] Male [illegible]
FULL [NAME OF FATHER]: [guess: Douglas] [illegible] [illegible] Sh[illegible] RESIDENCE: 625 [illegible] [illegible] COLOR: [guess: W] AGE AT LAST BIRTHDAY: 2[guess: 5] BIRTHPLACE: [illegible] OCCUPATION: [illegible]
FULL MAIDEN NAME [OF MOTHER]: [illegible] [illegible] [illegible] RESIDENCE: 65 [illegible] [illegible] COLOR: [guess: W] AGE AT LAST BIRTHDAY: 2[guess: 3] BIRTHPLACE: [illegible] OCCUPATION: [guess: House] [illegible]
Number of children [illegible] [illegible]
CERTIFICATE OF ATTENDING PHYSICIAN OR MIDWIFE [illegible signature] [illegible date]
---
CAUTION: SPECIAL HANDLING REQUIRED This material copied from records of National Personnel Records Center, St. Louis, Missouri to be used for reference only. Do not recopy or disseminate in its original form outside the Bureau.
---
DB Cooper-10660