Partial Transcript

OFFICIAL RETURN OF BIRTH BY PARENT OR GUARDIAN

Name of Child: Rozalio Ilnicky

Date of Birth: December 11, 1911

Where Born: Fort William

Sex: Female

Place of Parents Marriage: Fort William

When Married: 1907

Full Name of Father: John Ilnicky

Address: Fort William

Occupation: Labourer

Maiden Name of Mother: Maria Dzorec

Is she Single, Married or Widowed: Married

Name of Physician in Attendance: None

Name of Person Supplying Information: Mrs. Ilnicky

Address: Fort William

Date of Return: Sept 21, 1922

Affidavit included