Missouri State Archives
Missouri Birth & Death Records Database
Permanent Record of Births
County
Roll Number
Page
Number
Sullivan
C 6640
27
206
Date of Return (Month/Day/Year)
Name of Child
Sex
No. of Child of this Mother
Race or Color
Date of Birth
Place of Birth
7-3-1884
FEMALE
4
4-25-1884
SULLIVAN CO
Nationality of Father
Place of Birth
Age
Nationality of Mother
Place of Birth
Age
AMERICAN
SULLIVAN CO
30
AMERICAN
SULLIVAN CO
26
Full Name of Mother
Maiden Name of Mother
Residence of Mother
Full Name of Father
Occupation
Name and Address of Medical Attendant
Name and Address of Person making Certificate
Returned by
LURAY
ROGER
SULLIVAN
W. H. W. DEWITT
FARMER
J. DEWITT M.D.
NOTE
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