 | Massachusetts - 1902 - 44 halaman
...guardian or custodian] of [name of minor] , and that [he or she] was born at [name of city or town] , in the county of [name of county, if known] , and state [or country] of , on the [day and year of birth] , and is now [number of years and months] old. (Signature of father,... | |
 | United States. Bureau of Labor - 1904 - 1428 halaman
...(name of town or city) in the (name of county, if known) and State or county of , on the (day of birth ہ q 䀀 0 6 0 ̦ p Ɂ ؼ parent, guardian or custodian.) (City or town and date.) There personally appeared before me the above... | |
 | Massachusetts. Board of Education - 1904 - 70 halaman
...guardian or custodian] of [name of minor] , and that [he or she] was born at [name of city or town] , in the county of [name of county, if known] , and state [or country] of , on the [day and year of birth] , and is now [number of years and months] old. (Signature of father,... | |
 | 1904 - 1154 halaman
...guardian or custodian] of [name of minor], and that [he or she] was born at [name of city or town], in the county of [name of county, if known], and State [or country] of , on the [day and year of birth], and is now [number of years and months] old. (Signature of father,... | |
 | 1904 - 1426 halaman
...the county of [name of county, if known], and State [or country] of , on tne [day and year of hirth], and is now [number of years and months] old. (Signature of father, mother, guardian or custodian. ) (City or town and date. ) Then personally appeared l>efore me the above-named... | |
 | Rhode Island - 1906 - 20 halaman
...guardian, or custodian) of (name of child) and that (he or she) was born at (name of town or city) in the county of (name of county, if known) and state (or country) of on the (day and year of birth) and is now (number of years and months) old. "Signature of (father,... | |
 | Rhode Island. Factory inspectors - 1906 - 142 halaman
...guardian, or custodian) of (name of child) and that (he or she) was born at (name of town or city) in the county of (name of county, if known) and state (or country) of on the (day and year of birth) and is now (number of years and "months) old. "Signature of (father,... | |
 | 1907 - 1540 halaman
...(name of child), and that (he or she) was born at (name of town or city), in the county of (ьаше of county, if known) and State (or country) of (name),...and year of birth), and is now (number of years and of months) old. (Signature as provided in this act.) (Town or city, and date.) There personally appeared... | |
 | Josephine Goldmark - 1907 - 78 halaman
...mother, guardian or custodian) of (name of child) and that (he or she) was born at (name of town or city) in the county of (name of county, if known) and State (or country) of on the (day and year of birth) and is now (number of years and months) old. Signature of (father, mother,... | |
 | American Academy of Political and Social Science - 1907 - 264 halaman
...mother, guardian or custodian) of (name of child) and that (he or she) was born at (name of town or city) in the county of (name of county, if known) and State (or country) of on the (day and year of birth) and is now (number of years and months) old. Signature of (father, mother,... | |
| |
... [Signature of father, mother, or guardian]. [Town or city and date]. There personally appeared before me the above named [name of person signing] and made oath that the foregoing certificate by [him or her] signed is true to the best of [his or her]... 
