| Name | Αγκόπ |
|---|---|
| Surname | Σουρμελιάν |
| Father's Name | Οβανές |
| Age | 63 |
| Sex | Άρρεν |
| Occupation | |
| Origin | Σμύρνη |
| Spouses Name | Αννίτσα ετών 45 |
| Family Number | (not set) |
| Family Position | (not set) |
| Wife | Αννίτσα ετών 45 |
| Child | Σουρπουή ετών 14 |
| Signature | [Αρμ] |
| City | Hermoupolis |
|---|---|
| Year | 1922 |
| Number | 34022 |
| Request Year | 1922-12-14 |
| Place | Ερμ |
| Catalogue Date | (not set) |
| Comments | [Αρμ] |
| Residence | (not set) |
| Chronology | (not set) |
| Resort Year | 1922 |
| Committee Confirmation Attachment | Ναι |
| Arrival Log | No |