Form T-1 RECORD OF A BIRTH Place of Birth Gureford name Street No. Child's Name Endrew adelbertine Sardey Date of Birth march 9.1912 Sex Color W. Living or Stillborn giving No. of Child, 1st, 2nd, etc.- No. of children of this mother now living Legitimate or Illegitimate Leg Father's " Name Johnst McDarley Color or Race Age " Birthplace Gureford me " Residence Guifford me noten Father's millin Pinisher No. Street Occupation Ass Estellad. Natch Mother's Maiden Name N " Color or Race Age " Residence Grefford me " Birthplace Parkinan m " Occupation Name and address of Physician (or other person) reporting said birth, R. N Marshimo. Guelford Date when received by Town Clerk