H 32329 /1518 העיר רושלם החופה היתה ב ירושלם כיום 6 7 10 Name and Surname of Father and Mother Calling of Father and Mother Residence of

Wife האשה 19 כה Certified that the above is a true extract from the Register of Marriage kept at the office of 707/32329 of 1977 707 32329 in the