(1) Place of Birth: Hawley, Jones, Texas
(2) Full Name of Child: Lois
(3) Sex of Child: female
(6) Legitimate: Yes
(7) Date of Birth: Dec. 3, 1931
(8) Full Name Father: Otto Talley Lollar
(9) Residence, Post Office Address: Hawley, Texas
(10) Color: White
(11) Age at Last Birthday: 37 yrs.
(12) Birthplace: Mississippi
(13) Occupation: Farmer
(14) Full Maiden Name of Mother: Willie Lois Anderson
(15) Residence, Post office address: Hawley, Texas
(16) Color: White
(17) Age at Last Birthday: 35 yrs.
(18) Birthplace: Mississippi
(19) Occupation: Housewife
(20) Number of Children Born: 8
(21) Number of Children of this Mother now Living?: 8
(22) Certificate of Attending Physician or Midwife: Born alive at 7:30 P.M. Wm R Snow MD, Address, Abilene Texas
(23) Filed: 12-12-1931
Stamped: DECEASED, DOD 1-12-85, File #07341 [3 was marked over with 0 in file #]
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