Family No.
IN CITIES
of each person
whose place of abode
on April 15, 1910,
was in this family
PERSONAL DECSRIPTION
Mother
of how
many
children
T rans c ribed b y
NATIVITY
Naturalized/Alien
CITIZEN
OCCUPATION
1910
HOME
Blind in both eyes.
Deaf and dumb.
Supervisor's Dist. No.
Confed. or Union veteran
No. of farm enum.
Farm/house
EDUCATION
Free/mortgaged
Home owned/ rented
Attended school
Can write
Name of Incorporated place
Can read
Weeks out of work '09
Out of work Apr. 15
)
)
)
Employer, employee
or works on own
day of
General nature
of work
Trade or
Profession
Enumerated by me on the
Speaks English or other
1910 CENSUS
Year of immigration
to the U.S.
Place of birth
of mother
Place of birth
of father
Place of birth
No. living
Name of ins titution,
No. born
Township or other division of County
Single, married,
widowed, divorced
No. years of present
marriage
Age at last birthday
NAME
Color or race
LOCATION
Sex
County
Relation to
head of family
State
)
)
)
House No.
& street
Dwelling No.
Film Roll
UNITED STATES
Sheet No.
Enumeration Dist. No.
Ward of City
Enumerator
Date
6-0060