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Blank No. 14 Series II. Form B. 2.
(continued) 4 - Number of children? number reaching maturity? 4

Your Paternal Grandmother: home in city or country?
1 - age when married? young.
2 - Occupations? Before the day of Ladies' occupations.
3 - health?
4 - age and cause of death? About 42. Some acute
throat disease.

Your Mother: 1 - Nationality, if American of what descent? Scotch Irish.
2 - home in city or country before marriage? City
b) home in city or country after marriage? City
3 - Occupations before her marriage? Home work.
b) after her marriage? Rearing chldren.
4 - Note any prenatal influences before your birth.
5 - her health previous to your birth?
b -after your birth? She was always "well"
6 - Number of miscarriages? 1
7 - Her age if living and present health? if not, age at time
of death and cause: Seventy - good.
8 - how was your mother's health affected by the climacteric
(change of life). Not at all.
9 - name any diseases in her family.

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