Child's Name: Pearl Sampson
Date of Birth: May 18 1897
Place of Birth: Temple
Sex: Female
Color: White
Living or Stillborn: Living
No. of Child, 1st, 2nd, etc.: First
Falther's Name: Frank D Sampson
Falther's Birthplace: Temple
Falther's Color: White
Falther's Residence: Temple
Falther's Occupation: Carpenter
Mother's Maiden Name: Hortense Nite
Mother's Birthplace: Rangeley Me
Mother's Color: White
Mother's Occupation: Housekeeper
Name and address of Physician (or other person) reporting said Birth: J W Palmer, Farmington Me
