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[[ 4 columned table ]]
| NAMES | Age. | No. of Dependents. | REMARKS |
|---|---|---|---|

|   |   |   |   |

Executed in Presence of
H. T. Beltia
Ph. M. Reid

Transcription Notes:
Did not include "No. 183" etc. as that is page 129 https://transcription.si.edu/transcribe/28340/NMAAHC-007677373_01175