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  1. Birth
    xxx xxxx xxxxxxxxx xxx xxxxxxx
    Departure
    xx xxx xxxx xxx xxxx xxxxx xxx xxxxx xxx
    Arrival
    xx xxx xxxx Antwerp, Belgium
    Other
    xx xxx xxxx xxxxxxxxxx xxx xxxxxxxx xxx xxxxxxx
    Discharge Date
    x xxx xxxx
    Discharge Place
    xxxxxxxx xxxxxxx
  2. Birth
    xxx xxxx xxxxxxxxx xxx xxxxxxx
    Departure
    xx xxx xxxx xxx xxxx xxxxx xxx xxxxx xxx
    Arrival
    xx xxx xxxx Antwerp, Belgium
    Other
    xx xxx xxxx xxxxxxxxxx xxx xxxxxxxx xxx xxxxxxx
    Discharge Date
    xx xxx xxxx
    Discharge Place
    xxxxxxx xxxxxxx xxxxxxx xxx