CA1407

Lawrence C. Hines birth record at wvculture.org (West Virginia Department of Arts, Culture and History)
(C. Avis Catalog entry #1407)


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WEST VIRGINIA
STATE DEPARTMENT OF HEALTH
DIVISION OF VITAL STATISTICS

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CERTIFICATE OF BIRTH

MAKE OUT THIS CERTIFICATE OF BIRTH WITH ALL THE FACTS AS THEY WERE FOR THAT YEAR IN WHICH THE CHILD WAS BORN

County Webester
Town  Diana, West Virginia         Street ---

2. FULL NAME OF CHILD      Lawrence Cecil Hines
3. Sex of Child    Male
4. Twin:  ---   5. Order of birth  ---
6. Were parents married to each other?    Yes
7. Date of Birth    May 10 1910
8. Full Name Father    Michael Newlon Hines
9. P. O. Address    Deceased
10. Color or Race    White
11. Age of Father at time child was born    32
12. Father's birthplace    Town:  Sutton  State:  West Virginia
13. Occupation    Laborer
14. Name before marriage Mother    Amanda Evelyn Clifton
15. P. O. Address    Diana, West Virginia
16. Color or Race    White
17. Age of Mother at time child was born    26
18. Mother's birthplace    Town:  Diana  State:  West Virginia
19. Occupation    Housewife
20. How many children born to this mother up to and including this child    one
21. Did any of these children die before this child was born    No        If so, how many?

(Signature)    Amanda Evelyn Clifton Hines

Filed 12-22-39


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AFFIDAVIT OF ATTENDING PHYSICIAN, PARENT, NEAREST RELATIVE, OR OTHER PERSON HAVING KNOWLEDGE OF THIS BIRTH.

STATE OF        West Va.
COUNTY OF    Lewis

The undersigned, being first duly sworn, says that he is personally acquainted with the statements in the CERTIFICATE OF BIRTH as set forth upon the other side, and knows them to be true; that she is related to said child as    Mother
    (Signature)    Amanda Evelyn Clifton Hines

Subscribed in my presence and sworn to before me this 2nd day of Dec., 1939
    W. E. Rafferty, Notary Public of Lewis Co., WV
            My commission expires    Nov. 13 1949

Name and address of party sending in this certificate.
                    Name        Lawrence Cecil Hines
                    Address    243 Main St. Weston, W. Va.

Date    December 2, 1939