| Name |
Address |
Age
in Yrs |
D.O.B. |
Race |
| Sam Ausborn ( ? Osborn ) |
Gad Ky |
30 |
Jan 26 1887 ( Gad Ky ) |
White |
| Citizenship |
Occupation |
Employer |
Place
of Employment |
Nearest
Relative |
| Natural Born |
Farmer |
|||
| Height |
Build |
Eye
Color |
Hair
Color |
Date
of Reg. |
| Short |
Stout |
Black |
Black |
June 5 1917 |