| Father: | ____ - ____ | ||
| Mother: | ____ - ____ | ||
| Family 1: | Emilio Martinez | 21 AUG 19XX - 25 OCT 19XX | |
| 1) | Emilio Martinez | 13 NOV 19XX - ____ | |
| 2) | Rosalinda Martinez | 14 FEB 19XX - ____ | |
| 3) | Raul Martinez | 9 JUL 19XX - ____ | |
| 4) | Elsa Martinez | 1 SEP 19XX - ____ | |
| 5) | Ana Maria Martinez | 9 JAN 19XX - ____ | |
| 6) | Manuel Martinez | 6 OCT 19XX - ____ |
| Surnames/Apellido | all names/todos los nombres |