Certificate of Birth: Willie James Holmes

Date: About 3 Jan 1941 [unknown]
Location: Savannah, Chatham, Georgia, United States of America
Surnames/tags: Holmes Rudolph

Transcription of Willie James Holmes Certificate of Birth ^[1]:

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Contents 1 Certificate of Birth - Georgia Department of Public Health 1.1 1. Place of Birth 1.2 2. Usual Residence of Mother 1.3 3. Full Name of Child 1.4 4. Date of Birth 1.5 5. Sex 1.6 6. Twin or Triplet 1.7 7. Full Term Pregnancy - If not Give Months Gestation 1.8 Is Mother Married to Father of this Child? 1.9 Father of Child - 9. Full Name 1.10 10. Color 1.11 11. Age at Time of this Birth 1.12 12. Birth Place of Father 1.13 13. Usual Occupation 1.14 14. Industry or Business 1.15 15. Social Security No. 1.16 Mother of Child - 16. Maiden Name 1.17 17. Color 1.18 18. Age at Time of this Birth 1.19 19. Birth Place of Mother 1.20 20. Usual Occupation 1.21 21. Industry or Business 1.22 22. Social Security No. 1.23 23. Was this Child Born Alive? 1.24 24. total No. of Children Born to this Mother 1.25 25. L.R's. Own Signature 1.26 26. Date Filed 1.27 Date of Supplemental Report 1.28 27. I hereby certify that I attended the birth of this child who was born on the date stated above. The personal information as given on this certificat was furnished by

Certificate of Birth - Georgia Department of Public Health

State File No.: 58870

Registrar's No.: 2314

1. Place of Birth

(a) County: Chatham

(b) City or Town: Savannah, GA

(c) Name of Hosp. or St. Address: Georgia Infirmary

2. Usual Residence of Mother

(a) State: Georgia

(b) County: Chatham

(c) City or Town: Savannah

(d) House No. & or R.F.D. & Box: 819 Kline St

Hour of Birth: 11:25 PM

3. Full Name of Child

Holmes, Willie James

4. Date of Birth

Dec. 31, 1940

5. Sex

Male

6. Twin or Triplet

7. Full Term Pregnancy - If not Give Months Gestation

yes

Is Mother Married to Father of this Child?

yes

Father of Child - 9. Full Name

James Holmes

10. Color

Negro

11. Age at Time of this Birth

45

12. Birth Place of Father

South Carolina

13. Usual Occupation

Laborer

14. Industry or Business

15. Social Security No.

Mother of Child - 16. Maiden Name

Rosa Mae Rudolph

17. Color

Negro

18. Age at Time of this Birth

31

19. Birth Place of Mother

Georgia

20. Usual Occupation

Domestic

21. Industry or Business

22. Social Security No.

23. Was this Child Born Alive?

yes

24. total No. of Children Born to this Mother

1

(a) Born Alive/Now Living: 1

(b) Born Alive/Now Dead: 0

(c) Born Dead: 0

25. L.R's. Own Signature

Eve L. Righton

26. Date Filed

Jan 3, 1941

Date of Supplemental Report

12-8-43

J7a me

27. I hereby certify that I attended the birth of this child who was born on the date stated above. The personal information as given on this certificat was furnished by

Mr./Mrs.: Rosa Mae Rudolph

Related to this child as: Mother

Attendant's Own Signature: H.F Sharpen/Sharplen/Sharpler/Sharpley/Sharpless M.D

Attendant's P.O Address: Savannah, GA

Date Signed: 1-2-41