28

Blank no. 3 3 Form A.

1.Name in full. 25

2.Address. lth a)before marriage. Excellent. D

3. Date of birth. Jan 23, 1863.

4. Place of birth. Auburn. U.S.
Temperment.

5. Where educated; give degrees if any. Occupations before marriage. Give lenght of
time spent in each.

Taught two years in Grammar School. Two years in Normal School.

8. Nationality of mother.

American.

7. Nationality of father.

American

8. Age of [deleted]father[deleted] [inserted]mother[inserted] when married.

Twenty five.

9.Age of [deleted]mother[deleted] [inserted]father[inserted] when married.

10. General health of parents. Father asthmatic; health otherwise
good. Mother died of consumption.

11. Nationality of husband.

American.

12. Date of birth of husband.

Jan. 18, 1864.