2. USUAL RESIDENCE OF MOTHER:
(a) State: Vermont
(b) County: Addison
(c) City or town: Addison
(d) blank

3. Full name of child: Frederick Joseph Raymond
4. Date of birth: September 18, 1888
5. Sex: Male
6. blank
7. blank
8. Legitimate: Yes

FATHER OF CHILD
9. Full name: Frank Raymond
10: Color or race: White
11. Age at time of this birth: 36 years
12: Birthplace: France
13: Usual occupation: Lumberman
14: blank

MOTHER OF CHILD:
15: Full maiden name: Delema Patineau
16: Color or race: White
17: Age at time of this birth: 28 years
18: Birthplace: Canada
19: Usual occupation: Housewife
20: blank

21: Children born to this mother: 3

25. Information is verified by Adelord Cyr related to the child as uncle
26. Date received by local registrar: March 20, 1944
27: Registrar's signature: Beaurnelle H. Clark