Typewritten, Corrected Birth Certificate of Odell Cook
(C. Avis Catalog entry #1239)
(Document ID #662)
[Everything on the form is typed, even the 'Signature']
Use this form for correcting a certificate filed at the time the birth occurred. This form cannot be used for correcting records file through the probate court. 3528
TEXAS DEPARTMENT OF HEALTH
BUREAU OF VITAL STATISTICS
STANDARD CERTIFICATE OF BIRTH
STATE OF TEXAS
County of Kaufman
City: Scurry
Full name of Child: Odell Garrett Cook
Residence of Mother: Scurry, Kaufman County, Texas
Sex: Male
Legitimate?: Yes
Date of Birth: Jan 2 1918
Father: Doe Cook
Post Office: Scurry, Texas
Race: White
Age at time of Birth: 33 years
Birthplace: Eldorado, Arkansas
Trade: Farmer
Mother: Ruby Myrtle Garrett
Post Office: Scurry, Texas
Race: White
Age at time of Birth: 36 years
Birthplace: Surry, Texas
Trade: Housewife
Number of children born to this mother including this birth: 3
Number of children born to this mother and now living: 3
Signature of informant: Ruby Myrtle Cook [signed]
Address: 1612 Miller
Medical Attendance:
I hereby certify to the birth of this child BORN ALIVE at 7 A.M. on the above date
File No.: 204 File Date: 1-10-1918
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me on this day appeared Ruby Myrtle Cook, know ot me to be the person whose name is signed to the above certificate, who on oath deposes and says that the facts stated in the foregoing certificate are true and correct to the best of her knowledge and belief, and that this certificate is filed for the purpose of correcting the original record of the birth of Odell Garrett Cook
Signature: Ruby M. Cook
Sworn to and subscribed before me, this 4th day of February, 1942
J. V. Renfro
Notary Public in and for Tarrant County, Texas
L.S.