Town Hall of Turnu Severin Office of Civil Status
Extract #480
From the year nineteen hundred and three, October the eleventh at two p.m. Birth certificate of the child Eugenia, female, born today at five in the morning [illegible] at the House where her parents live at Unirea Street Number 25.
Daughter of Mr. Emerick Kultsar, forty-two years old, and Mrs. Elena E. Kultsar, thirty years old, a housekeeper, both from Severin.
Following the declaration made by the father who presented the Child to us - Witnesses were Mr. Ion Burlean, twenty-four years old, a clerk, and Mr. Constantin Valceanu, thirty-two years old, a coachman, both from Severin, who have signed this act along with the declarants and us after it was read to them -
Verified according to the law by us, N Voroveanu, Civil Status officer of the Town Hall of Severin, attested by Gr. M Tutelescu, Secretary of this office, office N Voroveanu.
Declarant: Emerik Kultsar Witnesses: I. Burleanu, C.N. Valceanu
This extract was issued according to the respective register after the municipal tax was paid with receipt Number 1034 / 903.
Officer N Voroveanu (signature)
Secretary (signature)
1902 October […]