Be it Remembered, That on this day to wit: the Tenth of January in the year of our Lord One Thousand, Nine Hundred and Seventeen and the One Hundred and 41 of the independence of the United States of America, before me, WM. T. O'REILLY, M. D., Chairman Board of Health and Ex-Officio Recorder of Births, Deaths and Marriages, in and for the Parish and City of New Orleans, personally appeared Samuel Peter Hughes, native of this city residing no. 708 Bartholomew street who hereby declares, that on the twentyninth of December 1916 (Dec 29 1916) at his residence was born a female child named Hazel Ethel Hughes. While ( ) Lawful issue of Deponent a native of this city aged 24 years, occupation Laborer and Philippine Ebbermann, a native of this city, aged 22 years. Thus done at New Orleans, in the presence of the aforesaid Samuel Peter Hughes as also in that of P. H. Lananze & M. J. Robinson both of this City witnesses by me requested so to be who have hereonto set their hands together with me, after due reading hereof, the day, month and year first above written. [Signatures]