Birth Certificate of Theresa Azzaro

(Note: The usual header and footer are missing, but otherwise it looks like a normal certificate)

Registration Number 364 (?)
When and where born: Twentyninth September 1871 5 Beer Lane Clewer Berks
Name if any: Theresa
Sex: Girl
Name and surname of father: Emanuel Assar
Name, surname and maiden name of mother: Ersler Assar formerly May
Occupation of father: Itinerant musician
Description and Residence of informant: Ersler Assar (signed with her mark) 5 Beer Lane, New Windsor
When registered: Thirtyfirst October 1871