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Name: (eg.: Hansen, Anton)
Occupation: (eg.: Smed)
Age:  
 
Last residence: (eg.: Randers)
Parish: (eg.: Randers)
County: (eg.: Randers)
 
Destination: (eg.: Chicago)
State: (eg.: Iowa)
Country: (eg.: USA)
 
Contract no: (eg.: 4586)
Date of reg: (eg.: 1892 og 9 (september 1892))

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