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■ |
Full legal name |
| ■ |
Other Name/Nick Names of the person |
| ■ |
Home address |
| ■ |
Village of residence |
| ■ |
Date of birth |
| ■ |
Place of birth |
| ■ |
Father's name |
| ■ |
Mother's maiden name |
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Other Name/Nick Names of surviving
relatives |
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2-3 Recent Photograph (select
nice photos) |
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Occupation |
| ■ |
Place of burial (if applicable) |
| ■ |
Clothing |
| ■ |
Clergy name and phone number |
|
■ |
Survivors (name and relationship)
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