TO MY Birth Certificates

My Grandfather Bernard M. Kohlbecker:

BIRTH RECORD FOR UNNAMED BABY BOY

1. Blank 2. sex :m 3. Number of children to mother: 5th

4. Date of this birth: 7-1-1913 5. Place of birth 916 s 11th Springfield

6. res of Mother 916 s 11 th Springfield

7. a. Birthplace of father: Springfield, Illinois Age: 40

b. Birthplace of mother: St. Louis, Mo. Age:37

8. Full name of mother: Mary Ann Kohlbecker 9.Maiden: Mary Ann Roth

10. Full name of father Peter Kohlbecker 11. Occupation: blank

Reported my ...C.W Compton midwife res 728 e Capitol

My Grandmother: Eulah Hildred Leek Kohlbecker Proctor

1. Place of birth: County of Jefferson

2. Full name of child Eulah Hildred Leek

3. sex: F 4. Single birth 5. Date of birth: 5-5-1917

6. Father : Emmit Leek 12: Mother: Linnie Beckham

7. res: R.F.D Mt. Vernon, Ill 13. res: RFD MT. Vernon, Ill

8. Color: White 9. Age:25 14. Color: White 15. Age:24

10. Birthplace: Illinois 16. Birthplace: Illinois

11. Occ: Farmer 17. Occ: Housewife

12: # of children you have with this wife:3 18.#of children with this husband:3

Physician..... J.W. Wells

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