3. When and where was your father born?
[typed] See Reverse Side
No. 7747 D
COPY OF BIRTH CERTIFICATE
FIFTY CENTS
Copy of Birth Certificate
Registration District No. 286
DEPARTMENT OF PUBLIC WELFARE
DIVISION OF HEALTH
BUREAU OF VITAL STATISTICS
CITY OF CLEVELAND
STATE OF OHIO
Registered No. 21707
1. PLACE OF BIRTH
a. County Cuyahoga
b. City, Village, Township Cleveland
c. Name of hospital or institution: St. John’s Hospital
Mother’s stay before delivery:In hospital or institution --
In this community --
2. USUAL RESIDENCE OF MOTHER
a. State: Ohio
b. County: Cuyahoga
c. City or village: Cleveland
Street No.: West 93rd St.
3. FULL NAME OF CHILD: Donald Jaster
4. DATE OF BIRTH: 8-10-1917
5. Sex: Male
6. Twin/Triplet [blank]
7. Number months of pregnancy: [blank]
7a. Weight at birth: [blank]
7b. Congenital malformation: [blank]
8. Is mother married? Yes
FATHER OF CHILD
9. Full name: August Jaster
10. Color or race: White
11. Age at time of this birth: 25 years
12. Birthplace: Cleveland, Ohio
13. Usual occupation: Laundry Salesman
14. Industry or business: --
MOTHER OF CHILD
15. Full maiden name: Margaret Sanders
16. Color or race: White
17. Age at time of this birth: 25 years
18. Birthplace: England
19. Usual occupation: Housewife
20. Industry or business: --
21. Children born to this mother not including this child: 0
a. How many other children of this mother are now living? 0
b. How many other children were born alive but are now dead? --
c. How many children were born dead? --
22. Date serologic test for syphilis --
a. If none, give reason --
23. Mother’s usual mailing address: West 93rd St.
24. I hereby certify that I attended the birth of this child who was born alive at the hour of A.M. on this date above state and that the information given was furnished by Mrs. Margaret Jaster related to this child as Mother.
25. Registrar’s signature: G. E. Harmon - M.D.
26. Date received by local registrar: Oct. 12, 1922
Signature: Dr. Schneider
Address: St. John’s Hosp.
I hereby certify that the above is an exact copy of the record of birth of Donald August Jaster which is on file in the Department of Health, Cleveland, Ohio.
Witness my hand and seal as Local Registrar of Vital Statistics on this 18th day of Nov. 1946.
/s/ J. G. Smith, Local Registrar
ON REVERSE:
Probate Court, Cuyahoga County, Ohio. Vol. 50B, Pg. 302 Case No. 364302
Filed - 11/15/46
NOTE: Case Number above is not related to Donald Jaster.