| Adoptee's Birthdate: |
NA |
| Birthplace: |
|
| Adoptee's Gender: |
Male |
| Multiple Birth: |
|
| BirthMother's Age: |
9 |
| Attorney/Agency |
|
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| Adoption Date: |
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| Adoption Location: |
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| Maternity Home: |
|
| Orphanage: |
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| Hospital: |
|
| Doctor: |
|
|
| local Cert: |
|
| Fedral Cert: |
|
| Caseworker: |
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| Case Number: |
|
| Judge: |
|
| Decree Date: |
|
|
