World
War I Draft Registration Card
|
No. 76
|
1 |
Name
in full: Fred
W. Fossitt
|
Age
Yrs: 23
|
2 |
Home
Address: Carntown,
Kentucky
|
3 |
Date
of Birth: September
30, 1893
|
4 |
Are
you (1) a natural-born citizen, (2) a
naturalized citizen, (3) an alien, (4)
or have you declared your intentions
(specify which)? Natural
Born |
5 |
Where
were you born? Kentucky
U.S.A.
|
6 |
If
not a citizen, of what country are you
a citizen or subject? |
7 |
What
is your present trade, occupation or
office? None |
8 |
By
Whom Employed?
Where
Employed? |
9 |
Have
you a father, mother, wife, child under
12, or a sister
or brother under 12 solely dependant on
you for support (specify which)? |
10 |
Married
or Single (which)? Single Race
(specify which)? Caucasian |
11 |
Nearest
relative? |
| 12 |
Do
you claim exception from draft (specify
grounds)? Insane
(patient at Eastern State Hospital) |
Registrar's
Report
|
Tall,
medium or short (specify which?) Medium
Slender,
medium or stout (which)? Stout
|
| Color
of eyes? BlueColor
of hair? RedBald? no |
Has person
lost arm, leg, hand, foot or both eyes,
or
is he otherwise disabled (specify)? |
| Answers
from records of Eastern State Hospital
for Insane |
