First Name:

Last Name:

Other Name:

Gender:

Marital status:

City:

Year of birth:

Takezo

Shiota

correct dob -Chronicle

M

Single

City

1990

Entry Type:

B

Entry Date:

07/14/1943

Departure Type:

Term

Departure Date:

01/13/1944

Destination City:

---------

Destination State:

----

Family #:

0000

Individual #:

0000

Citizenship:

C

Camp Address:

3-326-12-D

Farline Id:

id