Dane CCC R200218

Record Type: Petition

Family Name: Entwistle

Given Name: Mary Wallace

Family Name - Alternate (X- Name at top of card):

Given Name - Alternate:

Address: 1246 Spaight St. Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): Order Book page 128

Title/Location of Court: Circuit Court, Dane

Place of Birth: (See other side)

Date of Birth: Oct. 1, 1887

Certificate #:

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1: (over)

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age:

Date of admission:

Date Certificate Issued:

Petition #:

Alien Registration #: