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