..

DATE OF BIRTH DATE ENTERED REMARKS

AD D RESS
No. NAME OF BABY REMEMBRANCE pARENTS' NAMES
MONTH DAY YEAR MONTH DAY YEAR
 I I

ADDRESS REMARKS
( No. NAME OF BABY RE:(\'IEMBRANCE PARENTS' NAMES

,, , ~I .- ~

..
'• \'

•' ..
,, ''

..
-
·~
~~~~~~~~~~~
N~~~~~~~r===~~
"\.!\. _ .. . I
( DATE OF BIRTH DATE ENTERED
No. NAME OF BABY REMEMBRANCE PARENTS' NAMES ADDRESS ' REMARKS
MONTH DAY YEAR MONTH DAY YEAR

~:t·ff~b-
>

~.....,...._ -~~"'-9"-------'--=-------___:_'r_li ~~~~ct~ .1 •

 I -

DATE OF BIRTH DATE ENTERED '

No. NAME OF BABY REMEMBRANCE PARENTS' NAMES ADDRESS REMARKS
MONTH DAY YEAR MONTH D AY YEAR

61
~tZ._,B~P L_g_ ~3 tm ({)g;: /.2 ~ ~~!i
Jl , ,.. J ~

~~ QA.~l rli\;;J.
~ )... 9:.
62 (M. ~~ \~~1 \ll 1vw .
l'±_
1¥1 1A- lSf1£
~~l'~ ~~.:clo...Cl~o·~ it, ~, ,~
~
63
4 ~ U4-
~ ~
64
~ ~ IJ.utMJ~~~ ~ q- .,.
~ ~~;-<> ~M-aJ
-'t ~ II

+t"- \tk!f, \q )11"~"'1 il• ~ ~

~
65
-l, I qnly;
I
.. a lo 1"
a,.\ ~'13. ,
~~- ~M-a~
'I 2..
66
--l!t- ~ lt_ 1\ J ,~, . .. II

"
~ T\~ --,
II

-
67
~U\j l ~~""'W ~ w " +T -J..L--
~
I ~~
•
~·
/3
; 1.}-

~u.LL.. ~~lh~ ~ -~
. 68

~ lS;- ¥
U- t qoti ,, u __h__ ~·'lo,,~ro .;"O, Tl ' Ti h
u I I

69
1r'wJ ~%M LL acrYm. •• ti_ __lL__
:?"o
C1t!.2 'l. llw;;.-
1. 3 I ..,. I 0
"; 't
--
It .,,
" - II
70
j ~cl" 1)\~ ci~,cldrk In ~ 1~, ~~ ' II ____!L__ 11 , n'~ "
~ '.J:,

ti+Uf4
3..
71
~ ~ CI~ ~ ~ i-r ~ ~ ---"-- lL Jy ll II

tLJI~h.~~
. 3 4-
72
+o-r I _ll___
"
n TI z-,_, 1\ tl
_1--
~ <l A&H.l~ ~~ Q \N{, ,k D4 ~ . ..
~
73
h __ll_ _ ·. "• l~ ,,
74
~ ~ 6,.~ L~Lk 1wv: _L£_ _1\ _ ..
,____~~ 'it \
~ ~ ,, "
II

75 -~ ~ !\.4.0 -~1'\AM L ~,.( ij 1(\ ,.~,. I~' l qo~ ,I ,, II , . ,, .. .. ' ~d,

~·
~

\\ \ l1 \
REMEMBRANCE PARENTS' NAMES ADDRESS REMARKS
 ,../

PA RENTS' NAMES:
 I
DATE OF BIRTH D A TE ENTERED
NAME OF C H [LD REMEMBRANCE PARENTS' NAM ES ADDR ESS REMARKS
MONTH D AY Y E AR MONTH D AY YEAH

LLy &~- P~ .
,, .. ' ~ -.. . .,
 DA E OF BIRTH DATE ENTERED
No. NAME OF CHILD REMEMBRANCE
MONTH DAY YEAR MONTH DAY YEAR
 DATE OF BIRTH DATE ENTERED
No. NAME OF CHILD REMEMBRANCE PA R ENTS NAMES ADDRESS REM A RKS

II I(

. I/

t;

I \

< ,

1---
~
.. ~
.
·-- ..-
.
•t