PERSONAL |ROE RICHARD RANDOLPH |SEX IDENTIFICATION | | MALE |LAST NAME FIRST NAME MIDDLE NAME|-------------- |----------------------------------|RACE -------------------------| | W FINGERPRINTS SUBMITTED BY| |-------------- | |HT. |WT. |----------------------------------|(Inches)| |SIGNATURE OF PERSON FINGERPRINTED | 71 | 170 | |-------------- | 1655 Grant Avenue |DATE OF BIRTH |----------------------------------|6/6/42 -------------------------| Chicago, Illinois |-------------- FINGERPRINTED BY |--------------------------------- |HAIR |EYES |RESIDENCE OF PERSON FINGERPRINTED |BR |BR |------------------------------------------------- -------------------------|DATE FINGERPRINTED|LEAVE THIS SPACE BLANK PERSON TO BE NOTIFIED IN |8/12/62 | CASE OF EMERGENCY |------------------|CLASS NAME Thomas L. Roe |PLACE OF BIRTH | ------------------------- -------------------- |Omaha, Neb. | ADDRESS 1655 Grant Avenue|------------------| ----------------- |CITIZENSHIP | Chicago, Illinois|American |REF. -------------------------|------------------| -------------------------- See Reverse Side for |SCARS AND MARKS | Further Instructions |Appendectomy | --------------------------------------------------------------------------- 1. RIGHT THUMB|2. RIGHT INDEX|3. RIGHT |4. RIGHT RING |5. RIGHT | | MIDDLE | | LITTLE [Illustration]|[Illustration]|[Illustration]|[Illustration]|[Illustration] --------------------------------------------------------------------------- | | | | --------------------------------------------------------------------------- 1. LEFT THUMB |2. LEFT INDEX |3. LEFT MIDDLE|4. LEFT RING |5. LEFT LITTLE | | | | [Illustration]|[Illustration]|[Illustration]|[Illustration]|[Illustration] --------------------------------------------------------------------------- | | | | --------------------------------------------------------------------------- LEFT FOUR FINGERS |LEFT |RIGHT |RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY |THUMB |THUMB |TAKEN SIMULTANEOUSLY | | | [Illustration] |[Illustration]|[Illustration]|[Illustration]