<p> Ship manifest extraction form</p><p>Surname:______From List or Manifest at Port of Arrival</p><p>Ship: ______Manifest Page no.: ______Line:______</p><p>Sailing from ______Date: ______</p><p>Arriving at ______Date: ______</p><p>1 Line Number Person #1 Person #2 Person #3 Person #4 on List</p><p>Family 2 Name in Full Name Given Name 3 Age Years</p><p>Months 4</p><p>5 Sex</p><p>6 Married/SingleCalling/Occup ation</p><p>7 Able to: Read</p><p>Write 8</p><p>9 NationalityRace or People</p><p>Last Perm. 10 Country Residence City/Town 11 Name and address of nearest Final 12 relative/friend State inDestination country whence Alien City/Town 13 came. Line Number 14 on List Ticket to final 15 destination? Who paid 16 Havepassage? $50? If 17 notEver how in US much?before? Year or If yes: period Where? 18 Joining a relative/friend? 19 Who and Ever in prison, 20 where? asylum, etc? 21 A polygamist?</p><p>22 AnWhether Anarchist? 23 Mental and 24 Physical healthDeformed/crip pled? Nature 25 &Height cause Feet</p><p>Inches 26</p><p>Complexion 27 Color of Hair</p><p>Eyes 28 Marks of Identification 29 Place of birth Country City/Town</p><p>Transcribed by: ______</p><p>Transcription date: ______</p><p>Title of microfilm publication: ______</p><p>Publisher: ______</p><p>Microfilm roll # ______NARA pub.number: ______</p><p>Page No:______</p><p>Exact spelling of the primary name as indexed: ______</p>