Date of Birth: __-___-____ City: ______ County: ______ State: __ Country: ___
Parents: ______ ______ ______ & ______ ______ ______
Date of Marriage: __-___-____ to: ______ ______ ______ City: ______ County: ______ State: __ Country: ___
Children (1):
Date of Death: ::::::::::: City: :::::: County: :::::: State: :: Country: :::
Comments:
Last update 06-Jun-2009 ABS