81443-188580_278

State File Number: 65

County: Piute

Child's First Name: Wells

Child's Middle Name 1: Wakeman

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Dalton

Child's Suffix:

Sex: Male

Month of Birth (Number): 12

Day of Birth: 6

Year of Birth: 1914

Father's First Name: George

Father's Middle Name 1: Frank

Father's Middle Name 2:

Father's Surname: Dalton

Father's Title or Suffix:

Mother's First Name: Alice

Mother's Middle Name 1: M

Mother's Middle Name 2:

Mother's Maiden Name: Hall

Is there an Amendment?: No

Document Type: Certificate of Birth