81443-189328_095

State File Number: 1143

County: Weber

Child's First Name: Hendrina

Child's Middle Name 1:

Child's Middle Name 2:

Child's Middle Name 3:

Child's Surname: Schipper

Child's Suffix:

Sex: Female

Month of Birth (Number): 12

Day of Birth: 20

Year of Birth: 1914

Father's First Name: Adrian

Father's Middle Name 1:

Father's Middle Name 2:

Father's Surname: Schipper

Father's Title or Suffix:

Mother's First Name: Hendrina

Mother's Middle Name 1:

Mother's Middle Name 2:

Mother's Maiden Name: Kammaweyer

Is there an Amendment?: No

Document Type: Certificate of Birth