| Certificate Number | 155 | | Date Issued |
| Child Given Name | Phoebe Ball |
Harding | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 10 Mar 1889 |
New Albany Twp Story Co IA | Place of Birth |
| Father's Given Name | Robt. B. |
Harding | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | New York | 43 | Father's Age |
| Mother's Given Name | Jane | Wyatt | Mother's Maiden Name |
| Mother's Surname | | New Albany Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 38 | 7 | Number of Child This Mother |
| Medical Attendant's Name | J.I. Hostetter | Colo IA | Medical Attendant's Address |