First Name:

Last Name:

Other Name:

Gender:

Marital status:

City:

Year of birth:

Kingo

Takeda

​

M

Single

Casa Blanca

1929

Entry Type:

DE

Entry Date:

​

Departure Type:

Term W/G

Departure Date:

​

Destination City:

Venice

Destination State:

CA

Family #:

34124

Individual #:

34124C

Citizenship:

C

Camp Address:

1-13-10-D

Farline Id:

15894