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PLACE OF ABODE (1 /2 /3 /4) - Name (5) - RELATION (6) - HOME DATA (7/8/9/10) - PERSONAL DESCRIPTION - (11 Sex/12 Race/13 Age/14 Marital condition/15 Age at first marriage) - EDUCATION (16/17 Whether able to read) - PLACE OF BIRTH (18 PERSON / 19 FATHER / 20 MOTHER) - MOTHER TONGUE
(OR NATIVE LANGUAGE) OF FOREIGN BORN (21 Language spoken in home before coming to the United States/ CODE for office use only do not write in these columns (A/B/C/) - CITIZENSHIP (22/23/24) - OCCUPATION AND INDUSTRY (25 OCCUPATION... / 26 INDUSTRY... / D CODE... / 17 Class...) - EMPLOYMENT Whether actually at work...(28 Yes or No / 29 If not...) - VETERANS... (30 Yes or No / 31 What war...) - Number of Farm... - line # on form
382/234/243/Smith, George E/Head/R/20/_/No/M/W/32/M/20/No/Yes/Utah/Utah/Utah/_/94/_/_/_/_/Yes/Salesman/Canned Milk/4590/W/Yes/_/Yes/WW/_/74
_/_/_/~Amy [Ella]/Wife-H/_/_/_/V/F/W/32/M/20/No/Yes/Utah/Utah/Utah/94/_/_/_/_/Yes/None/_/_/_/_/_/_/_/_/75
_/_/_/~Amy/Daughter/_/_/_/V/F/W/9/S/_/Yes/_/_/Utah/Utah/Utah/94/_/_/_/_/_/None/_/_/_/_/_/_/_/_/76
_/_/_/~Leona/Daughter/_/_/_/V/F/W/6/S/_/Yes/_/_/California/Utah/Utah/98/_/_/_/_/_/None/_/_/_/_/_/_/_/_/77
_/_/_/~Camilla/Daughter/_/_/_/V/F/W/3 [& 5 mo]/S/_/No/_/_/California/Utah/Utah/98/_/_/_/_/_/None/_/_/_/_/_/_/_/_/78
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