English Translation

+or 420y2 H CV bternin vaccination of the prisoner (the following questions have to be answered truthfully.) 1. Surname and all first names? Hum preche ottokar This column is not filled by the (call name to be underlined) prisoner negno. bzernin birthday? 9.\.1909 2. place of birth? Dimotu; Ber. Podiebrad circle? . 3. Stand? earlier? profession? good business? read? confession of religion? Roman Catholic 4. When, where and in which church blessed or for the first time been a communion dimokue? 5. With whom did you raise? with the parents (with the parents or in another family? In an unstalt and where?) no Real Gymnasium 6. Which school did you attend? Were you in an institution or school for mentally handicapped children? Have you been in care education no 7. What is the reason for this? When? How long? My In which institution or in which no family were you in this school? Which craft did you learn my there? A. 25h.