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Transcription
PERSONAL IDENTIFICATION
Hobart Merritt Van Deusen
Name_
Soc. Sec. No.
Home Address 12 HIGHLAND AVE.
City MONTCLAIR Zone State N.J.
Home Telephone No. Mo.2-5409
Business Telephone No. TR.7-1300
Driver's License No.
Misc. Information. AMERICAN MUSEUM
OF NATURAL HISTORY,
CENTRAL PARK WEST AT
79 TH STREET, NEW YORK 24
In case of accident or serious illness please
notify at once.
Name_
Address_
City Zone State
Telephone No._