Husband’s Surname___________________ |
Given Name:__________________ |
His Father’s Name: ____________________________ His Mother’s Maiden Name: ____________________________ |
Birth Date: Birth Place: Death Date: Death Place: Burial Place: |
Wife’s Maiden Name ___________________________ Her Father’s Name: ____________________________ Her Mother’s Maiden Name: _____________________________ |
Birth Date: Birth Place: Death Date: Death Place: Burial Place: |
Marriage Date |
Marriage Place |
Children: |
Birth Date & Place |
Death Date, place & Burial Place |
Marriage Date, Place & Spouse |