C.R. 10. No. of Identity Certificate 30669
M.N.S. Region Regional No.
Christian Name Charles Herbirt
Rating Ch[ie]f Officer R.N.R. No. 001498
No. and Grade of B/T Certificate Ex Master
Date and Place of Birth 30/3/1874 Chorley Eng[land]
Nationality Brit[ish] Father Brit
Height Colour Hair Eyes
Dis. A No. N.H. Insurance No.
Name and Address of Next of Kin