First Name:

Last Name:

Other Name:

Gender:

Marital status:

City:

Year of birth:

Yutaka

Otake

Sam

M

Single

La Jolla

1901

Entry Type:

SaAC

Entry Date:

​

Departure Type:

Ind Empl

Departure Date:

​

Destination City:

Clearfield

Destination State:

UT

Family #:

4208

Individual #:

4208A

Citizenship:

C

Camp Address:

​

Farline Id:

12912